Chapter 7
The Art and Science of Policy
Making
© 2006 Thomson-Wadsworth
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.
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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.
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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
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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 setting
– Step 2 – Step 3 – Step 4 – Step 5 – Step 6 -
problem definition and agenda
formulation of alternatives
policy adoption
policy implementation
policy evaluation
policy termination
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The Process of Policy Making
• 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.
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The Process of Policy Making
• 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.
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The Process of Policy Making
• 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 nutritionrelated issues.
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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)
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The Process of Policy Making
– Policy Adoption
• The Human Resources division
includes:
– Centers for Medicare and Medicaid
Services (CMS)
– Administration for Children and
Families
– Administration on Aging
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The Process of Policy Making
– Policy Adoption
• 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
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The Process of Policy Making
– Policy Adoption
• 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.
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The Process of Policy Making
– Policy Adoption
• 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.
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The Process of Policy Making
• Policy implementation
– Putting the policy into action, which
involves employees of federal, state,
and local governments who work with
private organizations and interest
groups.
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The Process of Policy Making
• Policy evaluation
– Evaluation to determine if a program
is achieving its stated goals and
reaching its intended audience.
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The Process of Policy Making
• Policy termination
– This may occur for a number of
different reasons.
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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.
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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.
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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.
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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.
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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.
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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.
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How an Idea Becomes Law
• 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.
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How an Idea Becomes Law
• Once a bill becomes a law, it is
given the designation Public Law
and a number.
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How an Idea Becomes Law
• 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.
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How an Idea Becomes Law
• 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.
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Portion of a Final Rule
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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.
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The Federal Budget Process
• 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.
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The Federal Budget Process
• Principles of Federal Budgeting
– The federal fiscal year begins on
October 1 and runs through
September 30 of the following year.
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The Federal Budget Process
• 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.
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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.
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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.
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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
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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
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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
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The Legislative Process in
Real Life
• 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
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The Legislative Process in
Real Life
• 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
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The Legislative Process in
Real Life
• 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
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Current Legislation and
Emerging Policy Issues
• The American Dietetic Association
(ADA) is currently addressing six public
policy issues including:
–
–
–
–
–
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Medical nutrition therapy
Aging
Child nutrition
Nutrition research
Nutrition monitoring
Obesity
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Current Legislation and
Emerging Policy Issues
• Enacting state licensure laws in
those states that still do not have
a law remains a high priority for
the ADA.
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Current Legislation and
Emerging Policy Issues
• Other emerging policy issues
include:
– State Licensure Laws
– Bioterrorism and Food Safety
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Current Legislation and
Emerging Policy Issues
• 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
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The Community Nutritionist
in Action
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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.
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The Community Nutritionist
in Action
• 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
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Work to Influence the
Political Process
• Political Action Committees
(PACs)
– Help to raise funds to support
candidates or political parties.
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Work to Influence the
Political Process
• 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.
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Work to Influence the
Political Process
• Building Coalitions
– Working with other organizations
toward a common goal.
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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...
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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
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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.
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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.
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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
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Building Media Skills
• 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.
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Building Media Skills
• 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.
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Building Media Skills
• 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
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Building Media Skills
• 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
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Building Media Skills
• Writing a Letter to the Editor or an Oped 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)
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Sample letter to the
editor
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Building Media Skills
• Pitching Your Ideas On-line
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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"
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Building Media Skills
• 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.
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Building Media Skills
• 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.
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