1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 13 Policy Making and Community Health Advocacy

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Evolution and Effects of U.S. Health Policies Effects of policies: –Uninsured and underinsured –Economic effects Health care reform & downsizing Reduction in programs and services Nursing shortage Managed care Health care coverage Need for action to change

3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Political Action and Advocacy Social justice as foundation of public health nursing Public health nursing advocacy Community health advocacy Professional advocacy

4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Current Public Health Advocacy Grassroots efforts Lobbying Special interest groups Professional organizations

5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Advocacy is the foundation for public health nursing.

6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False –Social justice is considered the foundation of public health nursing.

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Policy Plan of action or agent outlining steps or actions to implement stated goal or objective Public policy: issued by national state or local governments Health policy: policy that constitutes the governing framework (structure, process, and outcomes) for providing health services on a local, state, national, or even international level –Distributive or redistributive –Regulatory health policy: competitive or protective

8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Public Policy Process similar to advocacy or political action Involves overlap, reordering of priorities, mobilization of resources, and development of stakeholders Issues of timing, funding, and politics

9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Policy Four major stages: –Formulation: goals, problems, & potential solutions –Adoption: authorized selection and specifications of means to achieve goals, resolve problems or both –Implementation: policy put to use –Evaluation: comparison of policy outcomes or effects with intended or desired effects (see Display 13.2)

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

11. Question Is the following statement true or false? Adoption is the first step in health policy development.

12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False –Formulation is the first step in health policy development.

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Influencing Policy Be honest. Start early. Know what you want. “KISS” No permanent enemies, no permanent friends Know your opponents. Compromise. There is strength in numbers. Work at the local level. Thank you (see Display 13.3).

14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Influencing Policy (cont.) Money as a major influence Relationships with legislators as key to policy development –Political action committees –Volunteering

15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Influencing Policy (cont.) Call for action –Being politically aware and active –Collaborating with community constituents and others –Learning to use policy systems and political process –Learning to formulate, implement, and evaluate health policies –Understanding the legislative process and how to influence it –Empowering self and others

16. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Money is a key factor underlying measures to influence policy.

17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True –A major influence on policy and being able to influence it is money.

18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Internet Resources American Nurses Association: http://www.nursingworld.org http://www.nursingworld.org Center on Budget & Priorities: http://www.cbpp.org/http://www.cbpp.org/ Citizen Joe: http://www.citizenjoe.orghttp://www.citizenjoe.org National Coalition on Health Care: http://www.nchc.org/ http://www.nchc.org/ U.S. House of Representatives: http://www.house.gov/ http://www.house.gov/ U.S. Senate: http://www.senate.gov/http://www.senate.gov/