legislative change, legislation, legislature, HB 308 Sub 2, APRN, nurses, nursing, advocacy, health policy, immunization bill, CHANGE, collecting data, hinge, associations, negotiate, gather, expect to be the expert, three readings, lobbying


Introduction: There is growing political apathy among nurses. This trend must be reversed to make meaningful change in healthcare. In 2017, the authors championed a bill, House Bill 308 Substitution 2 (HB 308 Sub 2), which passed in the Utah Legislature.

Guide: This health policy paper details the process of enacting HB 308 Substitution 2 to guide Nurse Practitioners in enacting legislation. The steps detailed to enact legislation are based on the acronym CHANGE which stands for collecting data, hinge, associations, negotiate, gather, and expect to be the expert. Basics of the legislature are also explained such as timing, the three readings, and lobbying.

CHANGE: Collecting data strengthens proposed legislation by legitimizing the problem and proposed solution. The hinge is deciding the approach to the solution, or the specifics of the proposed solution. Associations refer to involving key stakeholders early and often. Negotiate is the step of choosing a bill sponsor that is trustworthy, negotiates well, and has political capital. Gather means gathering public support. The more support from the public, the more likely the bill will pass. Expect to be the expert refers to knowing pro and con arguments and crafting power statements that convince legislators and answer common questions.

Conclusion: HB 308 Substitution 2 is a good start for Utah, but there is still much to do for vaccine legislation in Utah as well as in other spheres of healthcare nationally. Nurse Practitioners have the ability and responsibility to advocate for their patients and profession.

Document Type

Peer-Reviewed Article

Publication Date








University Standing at Time of Publication

Graduate Student


Nursing 631

Included in

Nursing Commons