© 2006 thomson-wadsworth chapter 7 the art and science of policy making

© 2006 Thomson-Wadsworth

Chapter 7

The Art and Science of Policy Making


Learning Objectives

• Describe the policy-making process.• Explain how laws and regulations are

developed.• Describe the federal budget process.• Identify a minimum of four emerging

policy issues in the food and nutrition arena.


Learning Objectives

• Prepare a letter addressed to your congressperson.

• Summarize the importance of policy making to nutritionists working in the community.

• Identify three ways in which the community nutritionist can influence policy making.


Introduction

• The purpose of public policy is to fashion strategies for solving public problems.

• In the nutrition arena, the strategies for solving problems typically include:– Food assistance programs– Dietary recommendations– Reimbursement mechanisms for nutrition

services


The Process of Policy Making

• Process/cycle by which authorities decide which actions to take to address a problem or set of problems:– Step 1 - problem definition and agenda

setting– Step 2 - formulation of alternatives– Step 3 - policy adoption– Step 4 - policy implementation– Step 5 - policy evaluation– Step 6 - policy termination



• Problem definition and agenda setting– The goal is to convince other people

that a public problem exists.– Once a problem is defined it is placed

on the policy agenda.– The issue must get into the

institutional agenda defined by each legislative body of the government.



• Formulation of alternatives– Most creative phrase of the policy-making

process.– Possible solutions to the problem are

devised and discussed by various groups.– In the United States, policy is formulated by

the legislative, executive, and judicial branches of government at the national, state, and local levels.



• Policy adoption– The tools or instruments for dealing

with the problem are chosen.– The Department of Health and Human

Services (DHHS) and the U.S. Department of Agriculture (USDA) are the two primary federal level departments that deal with nutrition-related issues.


The Process of Policy Making – Policy Adoption

• The mission of DHHS is to promote, protect, and advance the nation’s physical and mental health.

• The Public Health Service of DHHS includes: – National Institutes of Health (NIH)– Food and Drug Administration (FDA)– Centers for Disease Control and Prevention

(CDC)



• The Human Resources division includes: – Centers for Medicare and Medicaid

Services (CMS)– Administration for Children and

Families– Administration on Aging



• USDA’s mission is to: – Enhance the quality of life for all

Americans by working to ensure a safe, affordable, nutritious, and accessible food supply

– Reduce huger– Support the production of agriculture



• The Food and Nutrition Service of USDA administers the nutrition assistance programs.

• The mission of USDA’s Research, Education, and Economics division is to develop innovative technologies that improve food production and food safety.



• USDA’s Agriculture Research Service oversees research related to nutrient needs throughout the life cycle, food trends, the composition of the diet, nutrient interactions, and the bioavailability of nutrients.



• Policy implementation– Putting the policy into action, which

involves employees of federal, state, and local governments who work with private organizations and interest groups.



• Policy evaluation– Evaluation to determine if a program

is achieving its stated goals and reaching its intended audience.



• Policy termination– This may occur for a number of

different reasons.


The People Who Make Policy

• People involved in making policy are very diverse and vary from executives to elected officials.

• Once it has been decided that a policy should be put into effect, a choice must be made about how it will be implemented.


Legitimizing Policy

• Legitimizing policy is important because a policy may be perceived as benefiting some citizens and working to the detriment of others.

• Government must somehow legitimate each policy choice through mechanisms such as the legislative process, the regulatory process, or the court system.


The Legislative and Regulatory Process

• In the U.S., we associate lawmaking with Congress, the primary legislative body.

• Congress sets policy and supplies the basic legislation that governs our lives.


Laws and Regulations

• Laws passed by Congress tend to be vague and define the broad scope of the policy.

• Once a law is passed it is up to the administrative bodies, such as USDA, to interpret the law and provide detailed regulations or rules that put the policy into effect.


Laws and Regulations

• A weekly publication that contains all regulations and proposed regulations is called the Federal Register.

• The Code of Federal Regulations is the compendium of all regulations currently in force.


How an Idea Becomes Law

• A bill is introduced by sending it to the clerk’s desk where it is numbered, printed, and given a title.

• As bills work their way through the House and Senate, they are considered by several committees and subcommittees, which may hold public hearings and seek the testimony of interested persons before deciding whether to move the bill forward.



• If a bill approved by the Senate is identical to the one approved by the House, it is sent to the president to be signed.

• If the two versions differ there is a conference committee.

• The president may sign a bill into law, allow it to become law without his signature, or veto it.



• Once a bill becomes a law, it is given the designation Public Law and a number.



• Before a law enacted by Congress goes into effect, it is reviewed by the appropriate federal agency that is responsible for issuing guidelines or regulations that detail how the law will be implemented.



• These regulations are published as proposed regulations in the Federal Register and the public is given an opportunity to comment on the proposed rule.

• At the end of the comment period, the agency reviews all comments before issuing its final regulations that are incorporated into the Code of Federal Regulations.


Portion of a Final Rule


The Federal Budget Process

• Laws and regulations have no effect unless there are funds to enforce them.

• Congress must enact bills to fund the programs and services mandated by federal legislation.



• The Language of the Budget– The budget is the president’s financial plan

for the federal government.– The budget describes the following:

• Receipts or revenue.• Budget authority, which is the amount

government agencies are allowed to spend in implementing their programs.

• Budget outlays, which are the amounts actually paid out by government agencies.



• Principles of Federal Budgeting– The federal fiscal year begins on

October 1 and runs through September 30 of the following year.



• Budgeting principles (continued)– In terms of spending, congressional

committees must pass bills to authorize government programs.

– An authorization defines the scope of a program and sets a ceiling on how much money can be spent on it.

– Before money can be released to a program, an appropriation bill must be passed.


The Political Process

• The complexities of the legislative and policy-making process present many challenges.

• A recent example of the legislative process is the campaign by the American Dietetic Association to support Medical Nutrition Therapy (MNT) as a service provided by nutrition professionals.


The Political Process

• After eight years of effort, the president signed legislation that included the provision for creating new Medicare MNT benefits for patients with diabetes or kidney disease.


Medicare MNT Legislation

• S. 604—Medicare Medical Nutrition Therapy Act of 2005– Introduced March 11, 2005– Sponsor: Senator Larry Craig

• H.R. 1582—Medicare Medical Nutrition Therapy Act of 2005– Introduced April 12, 2005– Sponsor: Representative Fred Upton


Medicare MNT Legislation

• This bill seeks to amend title XVIII of the Social Security Act – Will authorize expansion of Medicare

coverage of medical nutrition therapy services

– Will allow the Secretary of Health and Human Services to determine future expansions of MNT coverage when scientific evidence shows it would be cost-effective


The Legislative Process in Real Life

• A bill submitted to the House was passed in 1904– Designed to protect consumers

against food adulteration, misbranding, and false advertising



• Senate began debating and eventually passed a similar bill, with amendments, in 1906– Chief chemist of the Department of

Agriculture testified about adulterated foods, bringing examples

– Women who were concerned about food safety also lobbied



• Bill went to the conference committee to iron out differences between the two houses

• President Theodore Roosevelt expressed support for the pure foods bill

• Bill passed both houses June 27, 1906• Signed into law by President Roosevelt

on June 30, 1906



• The Food and Drugs Act became law effective January 1, 1907, but...

• Congress failed to pass appropriation bills to provide the funds to enforce the law

• Congress failed to authorize the development of standards of food composition and quality

• Food adulteration remained a threat to public health


Current Legislation and Emerging Policy Issues

• The American Dietetic Association (ADA) is currently addressing six public policy issues including:– Medical nutrition therapy– Aging– Child nutrition– Nutrition research– Nutrition monitoring– Obesity



• Enacting state licensure laws in those states that still do not have a law remains a high priority for the ADA.



• Other emerging policy issues include: – State Licensure Laws– Bioterrorism and Food Safety



• Other emerging policy issues (cont.): – Biotechnology– Complementary and Alternative Medicine– Functional Foods and Nutraceuticals in the

Mainstream– The Growing Dietary and Herbal

Supplement Markets– The Human Genome and the Potential of

Genetic Screening


The Community Nutritionist in Action



• Make Your Opinion Known– Make your opinion known in a public

meeting or letter to the editor.

• Become Directly Involved– Run for political office, initiate a

campaign to bring an issue to the attention of the public, or participate on a local advisory board.



• Join an Interest Group– A body of people acting in an

organized manner to advance shared political interests.

• Work to influence the political process

• Take political action


Work to Influence the Political Process

• Political Action Committees (PACs)– Help to raise funds to support

candidates or political parties.



• Lobbying– Often the method of choice when trying to

influence the political system.– Lobbying - talking to public officials and

legislators to persuade them to consider the information you provide on an issue you believe is important.

– Knowing whom to lobby and when are critical decisions.



• Building Coalitions– Working with other organizations

toward a common goal.


Take Political Action

• Write effective letters to an elected official– Example: letter to a senator asking

for support of the Medicare Medical Nutrition Therapy Amendment bill...


Take Political Action

• Make effective telephone calls• Use e-mail effectively• Work with the media to help build

support for your position on an issue


Political Realities

• Your letters and political activities count because constituents can have more influence over elected officials than party officials have.

• Getting involved in the policy-making process is one way to strengthen your connections with other people and with your community.


Political Realities

• You can make a difference in your community by understanding the policy-making process, taking time to express your opinion, and being persistent and patient.


Building Media Skills

• Tips for working with media:– Be sure that the information you supply is

accurate– Become familiar with the format and types

of coverage of the various media and adapt your messages to the format of the media you choose

– Present scientific information in a concise, understandable manner and avoid technical language

– Be consumer-oriented



• General Guidelines for Working with the Media– Nurture good press relations with the

media contact people in your area.– When working with television or radio,

consider your appearance.



• Things you can do to encourage media to cover nutrition issues:– Send out a news release with a newsworthy

local story.– Write a letter “pitching” a story to a TV

station, newspaper or local magazine, including background information.

– Write a letter to the editor.– Call in to relevant radio shows to voice your

opinion on nutrition-related topics.



• Issuing a News Release– Write a gripping headline– Use a news “hook” or “spin” in the

first paragraph, followed by answers to the five Ws

– Write the news release succinctly and in the third person

– Make the opening statement strong



• Issuing a News Release (continued)– Include important quotations to tie the story

quickly to individuals who live in your area– List a contact name/telephone number– Include extra information in an

accompanying fact sheet or brief backgrounder



• Writing a Letter to the Editor or an Op-ed Piece – Look at similar pieces in the newspaper or

magazine as models– Contact the newspaper or magazine to see

whether it has specific guidelines to follow– Develop a strong news slant or a local

angle, with examples of real individuals– Include your name and affiliation (if writing

on behalf of the group)


Sample letter to the editor



• Pitching Your Ideas On-line– Who Will Develop the Website?– What Is the Purpose of the Website? – Who Is the Intended Audience?– How Long Should the Website Pages Be?

• Other Issues to Consider– Ease of use– Quality– "Netiquette"



• A Final Word About Content– Make your message easy to

understand and recall.– Focus on the positive.– Be certain your information is based

on sound scientific research.



• A Final Word (continued)– Be practical: Zoom in on specific

nutrition facts that can be easily applied.

– Be sure that your presentation exhibits cultural sensitivity and that your content is relevant.

– Tailor the information to your audience.

© 2006 thomson-wadsworth chapter 7 the art and science of policy making

Documents

process of policy

policy agenda

policy termination slide

science of policy

importance of policy

thomsonwadsworth slide

policy adoption step

policy evaluation step