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Submitter: Karen Van Hentenryck

Issue: At one time the GOM included mention of the Key Member as able to withdraw a negative submitted by an organizational voter on review or normative ballots when the submitter did not respond to messages regards resolution of their negative vote. However, ANSI found the designation of an “anonymous” proxy, i.e. not named, to be unacceptable. The GOC should consider a process for the implementation of an acceptable proxy; particularly on normative ballots.

Analysis

At issue, HL7 has no recourse for those individuals who submit a Normative Ballot and cannot subsequently participate in or respond to the reconciliation process or, if needed, a recirculation ballot.  In particular, ANSI is not supportive of a blanket statement to the effect that the designated Key Member of an Organization or Affiliate may stand as proxy for their designated voting representatives.  Thus, apparently, requiring a named individual to act as the submitter’s agent should they be unable to “complete” the ballot process.

Assigning a proxy in situations where one is are not able to attend, for example, a stockholder’s or HOA meeting is familiar to most everyone.  It is a clearly defined, legal process that allows us to designate another to cast a vote for us; usually in some limited capacity.  Unfortunately, this context is neither applicable or acceptable for use in the Normative Ballot process.  The closest and most familiar proxy form relevant to HL7’s needs is, surprisingly, the Advanced Healthcare Directive or Healthcare Proxy.

The Healthcare Proxy is a document in which an individual appoints an agent to make healthcare decisions on their behalf should they become unable to do so for themselves.  Within the realm of proxies, this is often referred to as a “springing” proxy; in that it only takes affect (springs into action) under specific circumstances. This model could prove workable for our ballot process.

Suppose that using the JIRA ballot tooling HL7 could, as an option at ballot-submitter account creation, include a statement to the effect:

As relates to [Ballot Name supplied by JIRA], should the responsible Work Group be unable to communicate with me, using the email address provided with this submission, in the course of reconciliation or the issuance of a recirculation ballot; I designate [Person’s Name/Email Address] to act as my agent to complete such actions relevant to [Ballot Name supplied by JIRA].

While not mandatory for registration, hopefully our Organizational and Affiliate Members would be willing to have their ballot submitters complete the “proxy” statement, particularly when their submission states that they mirror “Joe Key Member’s” submission’ i.e., a consolidated ballot. Even HL7 Individual Members may appreciate having the option to name a proxy; although it should probably stipulate that said proxy must be a HL7 member. Having such a statement attached to a submitted ballot may comply with ANSI’s unstated requirement for a named proxy and provide at least some additional closure on HL7 ballots.

It is recommended that the ability of JIRA ballot tooling to include a proxy statement be confirmed.  Further, a call should be scheduled with ANSI to confirm that such an approach would be acceptable.

Response from ANSI: [Anne Caldas] Although not an expert in this area, a call is probably not necessary given that Proxy is defined in ANSI Essential Requirements; further only a few developers use proxy voting.

ANSI ER 2019
Annex A: Definitions
Proxy: A written and signed document by which a voting member of a consensus body authorizes another person to vote in the member’s stead, if allowed by the developer’s procedures.

Follow up: Given that ANSI recognizes electronic communications as synonymous with written communications, would the statement above suffice as a written and signed document since it would be voluntarily completed as a component of joining a consensus group for any given ballot? 

Further thoughts:

From IPC Standardization Procedures §4.4.1

The ballot group consists of voters who represent a specific site/location (company site, consultant, mailing address, etc.). IPC allows only one vote per site/location.

In cases where a voting member of the consensus ballot group is unable to fulfill their commitment to ballot (e.g., illness, retirement, termination, etc.), that person or an agent from the company must contact IPC in writing and provide another person from the voting site to act as proxy. Without written authorization, a vote received from anyone other than the voting member will not be counted in the tally.

Additionally, it is the responsibility of a balloter who has changed company location, interest category, etc., during the ballot group formation stage to notify IPC of this change in writing.

There will be no additions to or removals of voting sites from the ballot group and no changes to interest categories once the ballot is distributed.

From IPC Standardization Procedures §4.4.1.1

IPC allows one vote per company location. If two or more individuals from the same company location request to be a balloting member, they are contacted and advised to coordinate their votes and assign a primary balloter to participate on the consensus ballot group. An alternate balloter (proxy) may be designated if the primary balloter is unable to vote for any reason, i.e., the voting member is no longer with the company.

As I suspected, IPC allows only one vote per organization much like ASC X12.  Therefore, I don’t believe we can take the IPC process verbatim.  It stipulates that the ballot response, if not submitted by the voter or their proxy, will not be accepted.  We, on the other hand, are dealing with the response to the disposition of negative comments in the hopes of a withdrawal of the negative versus the submission in the first place.  IPC has no issues in this area given their stated policy on accepting votes and due to the fact that they mail each voter a written response to negative comment dispositions. 

HL7 proxy process prior to GOM update 8/26/2013 in response to ANSI Audit

03.06 Designated Voting Representative Proxy

The designated Key Representative of an organizational or Affiliate member shall hold proxy for that member’s designated voting representatives who are unable, for whatever reason, to respond to the disposition of negative comments specific to a normative issue.  The Key Representative shall exercise their proxy only after a reasonable attempt to engage their respective voting representatives.

14.10.02 Execution of Organizational or Affiliate Representative Proxy

In the event that a voting member is unable, for whatever reason, to respond to the disposition of a negative ballot, the Key Member of that organization or Affiliate shall execute their proxy (§03.06).

Possible solution given that we were in favor of the IPC solution of having the organization submit a proxy statement:

ADD:

03.03.02 Organizational Members Key Voting Representative

Each Organizational Member shall identify a Key Voting Representative by name to HL7 Headquarters.  The Key Voting Representative shall maintain a current file of signed statements from each of their organization’s designated voting representatives naming the Key Voting Representative as proxy in matters pertaining to the reconciliation or recirculation of HL7 normative ballots.  

The proxy statement may take the form of: "Having submitted a HL7 Normative ballot, should I be unable to respond, for whatever reason, to the subsequent notice of disposition of negative comments or the recirculation of said Normative ballot I designate [name of Key Voting Representative] as my agent to complete such actions."

03.09.01 Affiliate Members Key Voting Representative

Each Affiliate Member shall identify a Key Voting Representative by name to HL7 Headquarters.  The Key Voting Representative shall maintain a current file of signed statements from each of their designated voting representatives naming the Key Voting Representative as proxy in matters pertaining to the reconciliation or recirculation of HL7 normative ballots.  

The proxy statement may take the form of: "Having submitted a HL7 Normative ballot, should I be unable to respond, for whatever reason, to the subsequent notice of disposition of negative comments or the recirculation of said Normative ballot I designate [name of Key Voting Representative] as my agent to complete such actions."

REVISE:

02.11.01 Fulfilling Notification of Disposition Requirements

02.11.01.01 Individual Members

If the attempt to notify an organization or Affiliate member representative of the disposition of their negative comments via the Ballot Desktop is unsuccessful, the responsible co-chair will notify HL7 Headquarters who shall forward such notification to the organization or Affiliate’s Key Member fulfilling the requirement of notification. 

If the attempt to notify an individual member of the disposition of their negative comments via the Ballot Desktop is unsuccessful, the attempt shall be considered reasonable and prudent and shall fulfill the requirement of notification of disposition.

02.11.01.02 Organizational or Affiliate Member Voting Representatives

If the attempt to notify an Organizational or Affiliate member voting representative of the disposition of their negative comments via the Ballot Desktop is unsuccessful, the responsible co-chair will notify HL7 Headquarters who shall forward such notification to the organization or Affiliate’s Key Voting Representative. 

The Key Voting Representative shall, if unable after a reasonable attempt to engage their respective voting representative, forward a copy of their voting representative’s proxy statement to HL7 Headquarters and respond to the disposition of negative comments.

Proposed Revision


GOM

03.03.02 Organizational Member's Key Voting Representative

Each Organizational Member shall identify a Key Voting Representative by name to HL7 Headquarters.  The Key Voting Representative shall maintain a current file of signed statements from each of their organization's designated voting representatives naming the Key Voting Representative as proxy in matters pertaining to the reconciliation or recirculation of HL7 Normative ballots.

It is suggested that the proxy statement take the form of: "Having submitted a HL7 Normative ballot, should I <name of designated voting representative> be unable to respond, for whatever reason, to the subsequent notice of disposition of negative comments or the recirculation of said Normative ballot I designate <name of Key Voting Representative> to act as my agent and complete such actions.

03.09.01 Affiliate Member's Key Voting Representative

Each Affiliate Member shall identify a Key Voting Representative by name to HL7 Headquarters.  The Key Voting Representative shall maintain a current file of signed statements from each of their designated voting representatives naming the Key Voting Representative as proxy in matters pertaining to the reconciliation or recirculation of HL7 Normative ballots.

It is suggested that the proxy statement take the form of: "Having submitted a HL7 Normative ballot, should I <name of designated voting representative> be unable to respond, for whatever reason, to the subsequent notice of disposition of negative comments or the recirculation of said Normative ballot I designate <name of Key Voting Representative> to act as my agent and complete such actions.

ER

02.11.01 Fulfilling Notification of Disposition Requirements

If the attempt to notify an organization or Affiliate member representative of the disposition of their negative comments via the Ballot Desktop is unsuccessful, the responsible co-chair will notify HL7 Headquarters who shall forward such notification to the organization or Affiliate’s Key Member fulfilling the requirement of notification. 

02.11.01.01 Individual Members

If the attempt to notify an individual member of the disposition of their negative comments via the Ballot Desktop is unsuccessful, the attempt shall be considered reasonable and prudent and shall fulfill the requirement of notification of disposition.

02.11.01.02 Organizational or Affiliate Member's Voting Representatives

If the attempt to notify an Organization or Affiliate member's voting representative of the disposition of their negative comments via the Ballot Desktop is unsuccessful, the responsible Work Group co-chair will shall notify HL7 Headquarters who shall forward such notification to the Organization or Affiliate’s Key Voting Representative Member fulfilling the requirement of notification.  

The Key Voting Representative shall, if unable after a reasonable attempt to engage their respective voting representative, forward a copy of said voting representative's proxy statement, if available, to HL7 Headquarters.  Upon submission of the voting representative's proxy statement, the named proxy shall respond to the disposition of negative comments.  Proxy statements shall be retained with the ballot material for audit purposes. 

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