The Art and Science of Policy Making

Chapter 7 The Art and Science of Policy Making

Lecture Launcher

Do you view yourself as a political animal?

Chapter Outline

I. Introduction

A. The purpose of public policy is to fashion strategies for solving public problems. B. In the nutrition arena, the strategies for solving problems typically include: 1. Food assistance programs. 2. Dietary recommendations. 3. Reimbursement mechanisms for nutrition services.

II. The Process of Policy Making

A. Policy making is the process by which authorities decide which actions to take to address a problem or set of problems and it can be viewed as a cycle: 1. Problem definition and agenda setting. Problem definition and agenda setting is the first step and the goal is to convince other people that a public problem exists. a. Once a problem is defined it is placed on the policy agenda. b. The issue must get into the institutional agenda defined by each legislative body of the government. 2. Formulation of alternatives. The second step is formulation of alternatives and this is the most creative phrase of the policy-making process. a. Possible solutions to the problem are devised and discussed by various groups. b. In the United States, policy is formulated by the legislative, executive, and judicial branches of government at the national, state, and local levels. 3. Policy adoption. The third step is policy adoption where the tools or instruments for dealing with the problem are chosen. a. 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. b. The mission of DHHS is to promote, protect, and advance the nation’s physical and mental health. c. The Public Health Service of DHHS includes the National Institutes of Health (NIH)), the Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC). d. The Human Resources division includes the Centers for Medicare and Medicaid Services (CMS) that administers the Medicare and Medicaid programs, the Administration for Children and Families, and the Administration on Aging.

IM for Community Nutrition in Action 4e, by Melanie Burns of Eastern Illinois University e. 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; and support the production of agriculture. f. The Food and Nutrition Service of USDA administers the nutrition assistance programs. g. The mission of USDA’s Research, Education, and Economics division is to develop innovative technologies that improve food production and food safety. h. 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. 4. Policy implementation. The fourth step in the policy cycle is policy implementation, or putting the policy into action, which involves employees of federal, state, and local governments who work with private organizations and interest groups. 5. Policy evaluation. The fifth step is policy evaluation to determine if a program is achieving its stated goals and reaching its intended audience. 6. Policy termination. The sixth step of the policy cycle is policy termination, which may occur for a number of different reasons.

B. The People Who Make Policy 1. People involved in making policy are very diverse and vary from executives to elected officials. 2. Once it has been decided that a policy should be put into effect, a choice must be made about how it will be implemented.

C. Legitimizing Policy 1. Legitimating policy is important because a policy may be perceived as benefiting some citizens and working to the detriment of others. 2. Government must somehow legitimate each policy choice through mechanisms such as the legislative process, the regulatory process, or the court system.

III. 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.

A. Laws and Regulations 1. Laws passed by Congress tend to be vague and define the broad scope of the policy. 2. 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. a. A weekly publication that contains all regulations and proposed regulations is called the Federal Register. b. The Code of Federal Regulations is the compendium of all regulations currently in force. B. How an Idea Becomes Law 1. A bill is introduced by sending it to the clerk’s desk where it is numbered, printed, and given a title. 2. 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. 3. 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.

IM for Community Nutrition in Action 4e, by Melanie Burns of Eastern Illinois University 4. If the two versions differ there is a conference committee. 5. The president may sign a bill into law, allow it to become law without his signature, or veto it. 6. Once a bill becomes a law, it is given the designation Public Law and a number. 7. 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. 8. These regulations are published as proposed regulations in the Federal Register and the public is given an opportunity to comment on the proposed rule. 9. 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.

C. 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.

1. The Language of the Budget a. The budget is the president’s financial plan for the federal government. b. The budget describes the following: 1. Receipts or revenue. 2. Budget authority, which is the amount government agencies are allowed to spend in implementing their programs. 3. Budget outlays, which are the amounts actually paid out by government agencies. 2. Principles of Federal Budgeting a. The federal fiscal year begins on October 1 and runs through September 30 of the following year. b. In terms of spending, congressional committees must pass bills to authorize government programs. 1. An authorization defines the scope of a program and sets a ceiling on how much money can be spent on it. 2. Before money can be released to a program, an appropriation bill must be passed.

IV. 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.  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.

A. 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, and 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 bioterrorism and food safety, the labeling of dietary fats, biotechnology, complementary and alternative medicine, functional foods and

IM for Community Nutrition in Action 4e, by Melanie Burns of Eastern Illinois University nutraceuticals, medical foods, the growing dietary and herbal supplement markets, and the implications of the results of the Human Genome Project.

1. State Licensure Laws 2. Bioterrorism and Food Safety 3. Biotechnology 4. Complementary and Alternative Medicine 5. Functional Foods and Nutraceuticals in the Mainstream 6. The Growing Dietary and Herbal Supplement Markets 7. The Human Genome and the Potential of Genetic Screening

V. The Community Nutritionist in Action  There are many ways in which community nutritionists can influence the policy-making process:

A. Make Your Opinion Known. Make your opinion known in a public meeting or letter to the editor. B. Become Directly Involved. Become directly involved by running for political office, initiating a campaign to bring an issue to the attention of the public, or participating on a local advisory board. C. Join an Interest Group. Join an interest group which is a body of people acting in an organized manner to advance shared political interests. 1. Work to Influence the Political Process a. Political Action Committees (PACs). Work to influence the political process by contributing to a Political Action Committee (PAC), which helps to raise funds to support candidates or political parties. b. Lobbying. Lobbying is often the method of choice when trying to influence the political system. 1. Lobbying means talking to public officials and legislators to persuade them to consider the information you provide on an issue you believe is important. 2. Knowing whom to lobby and when are critical decisions. c. Building Coalitions. Build coalitions by working with other organizations toward a common goal. 2. Take Political Action a. Write Effective Letters. Write effective letters to an elected official. b. Make Effective Telephone Calls c. Use E-mail Effectively d. Work with the Media. Work with the media to help build support for your position on an issue.

D. Political Realities 1. Your letters and political activities count because constituents can have more influence over elected officials than party officials have. 2. Getting involved in the policy-making process is one way to strengthen your connections with other people and with your community. 3. 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.

IM for Community Nutrition in Action 4e, by Melanie Burns of Eastern Illinois University