HEALTH ADMINISTRATION & POLICY Assorted Slides K. Noonan, J. Tew & A.

HEALTH ADMINISTRATION & POLICY Assorted Slides K. Noonan, J. Tew & A. Starapoli May 2020 1

WHAT IS PUBLIC POLICY? What is public policy? A government resolution to a public problem What constitutes a public problem? Public problems are conditions that the public feels are unacceptable and require intervention Could be policy problem, could be public health problem Where does public policy occur? At all levels of government Within different government institutions 2

REVIEW: FEDERAL, STATE AND LOCAL GOVT Federal Government Legislative Branch (U.S. Congress) Executive Branch (POTUS, HHS) Judicial Branch (SCOTUS) Creates laws (i.e., statutes), pass budget, monitor programs Enforce laws, implement programs Adopt rules and regulations Interpret laws, regulations and other rules, resolve conflicts State Government Legislative Branch (PA General Assembly) Executive Branch (PA Governor, PA DoH) Judicial Branch (PA Unified Court System) Creates laws (i.e., statutes), pass budget, monitor programs Enforce laws, implement programs Adopt rules and regulations Interpret laws, regulations and other rules, , resolve conflicts Local Government Legislative Branch (Philly City Council) Executive Branch (Philly Mayor, Philly DoH, BoH) Judicial Branch (Philly Municipal Court) Creates laws (i.e. ordinances), pass budget, monitor programs Enforce laws, implement programs Adopt rules and regulations Interpret laws, regulations and other rules, , resolve conflicts 3

REVIEW: LEGISLATIVE POLICYMAKING INTRODUCTIO N Bill Introduced in House Much legislation begins as similar proposals in both houses Bill Introduced in Senate COMMITTEE ACTIONto Referred House committee, which holds hearings and recommends passage Referred to Senate committee, which holds hearings and recommends passage FLOOR ACTION ENACTMENT INTO LAW House debates and passes House and Senate members confer, reach compromise on all differences between the two versions Senate debates and passes House and Senate approve compromise President signs into law All bills must be approved by the House and Senate in identical form before they can be sent to the President 4

ADMINISTRATIVE POLICYMAKING IS ALSO VERY IMPORTANT Policymaking that occurs by non-elected employees of government agencies Diff erent mechanisms: Rules, guidance, “other” gray policy Administrative Policy vs. Legislative Policy “Shadow” 4th branch of government 5

ALWAYS MULTIPLE STAKEHOLDERS IN POLICY & ADVOCACY WORK Government/Agencies Federal, state, city Providers Employers/Unions Insurance/Payers Communities/Neighborhoods Families/Consumers Foundations Media Advocacy Groups 6

POLICYMAKING INVOLVES CONSIDERING MULTIPLE OPTIONS Essential elements of the analysis Issue Statement/Problem Statement Background on Issue/Landscape (players) Options (never consider options until you have the correct problem statement) Recommendation 7

IDENTIFYING OPTIONS Consider typical policy actions Gov’t providing or purchasing a good for public Taxing or subsidizing to achieve outcome Passing laws and regulations to require action Education and information to persuade action Always consider the status quo Identify 3 to 5 best suited alternatives GO BACK TO PROBLEM to make sure options squarely address problem 8