Public Health Policy Process

¶ … Policy Process Part I

Policies are constantly being reviewed and considered to assist in enhancing the federal, state, and local health care systems. Each of the reviewed and considered policies has the potential to affect every individual on a daily basis, so careful consideration must be exercised when policies are proposed. The careful consideration requires an understanding of the process through which an idea or topic ultimately becomes a policy and legislation. An example of a topic in the health care industry that may be used to form a policy is health workforce shortages. This topic can become a policy because the United States health sector is currently experiencing an increase in workforce shortages in federal, state, and local levels. The current laws do not have adequate measures or procedures that would deal with this issue effectively. Therefore, policy makers should develop and implement legislation that specifically focuses on health workforce shortages.

Objective of the Policy

The objective of this policy is to address health workers shortage by ensuring that health care facilities enforce a staffing plan that incorporates a minimum direct care registered nurse-to-patient ratio by department. Moreover, the policy will address the issue by promoting the establishment of measures that will increase the numbers of health professions students to meet the demands of future health services. The policy will address supply side issues through enhancing recruitment, retention, and keeping in touch with the existing workforce to deal with any emerging issues. Secondly, the policy will deal with health workforce shortage through addressing demand side challenges by providing opportunities and avenues for health workers to utilize their skills effectively. Thirdly, the policy will provide clarity of roles between health workers and a balance between these professionals (Buchan & Aiken, 2010, p.3262).

Formulation Stage

The formulation of public health policy in the United States is not a tidy process because of the involvement of federal, state, and local governments (Gebbie, 1994, p.888). The disorganization associated with this process is attributed to the inconsistencies in the breadth of power granted to executive agencies across the three levels legislative bodies. In some situations, the formulation stage is characterized with broad statutory language through which agencies are granted broad powers to define issues, stipulate public action, and guide staff attention to a public issue. In other situations, policies go through comprehensive details regarding particular situations or conditions that require the application of a specific action. As a result, the ability of public health officials to exercise their discretion in personal applications is increasingly limited.

Policy formulation can be described as the process through which proposed measures are expressed, discussed, and outlined into a language for policy or law. During this stage, written policies and laws are constantly drafted and revised before being finalized. For this health care topic, the policy will be drafted by experts from different health care fields across the federal, state, and local governments. These experts will set the goals and outcomes of the health policy and stipulate the relevant activities and indicators for the achievement and evaluation of these goals. Some of the goals of this policy include creation of more employment opportunities in the health sector, encouraging more people to enroll for courses in different health professions, and ensuring appropriate nurse-patient ratio in health facilities. The activities related to these goals or process includes advocacy, policy dialogue, and data analysis. The experts will also work with legal advisors and policy makers to ensure the written policy is drafted into a language for health policy before being finalized.

Legislative Stage

Similar to the formulation stage, the legislative stage is a complex process given that the Congress usually considers proposed bills for a long period of time that ranges from months to years. Once the policy or bill has been drafted, it can be introduced in the Senate or House of Representatives through a member of Congress who supports it. This will be followed by numbering the bill and referral to a committee as well as printing by the Government Printing Office. The committee will then place the bill on its calendar for discussions that focus on the content and language of the policy. The next step in this process is scheduling for floor action, which involves reporting the bill back to its chamber of origin. A debate will be carried out on the legislation based on the specific regulations or procedures that govern debate before voting is carried out. This will be followed by referral to other chamber, conference committee action, and final floor action where it is passed and sent to the president for his signature.

Notably, for this health care topic, the legislative stage will involve participation of the three levels of legislative bodies. There is need for concerted efforts from federal, state, and local governments because of the severity of health worker shortages and its increased impact on the delivery of high-quality health services. Public health agencies in these levels of governments must be organized effectively to engage in the legislative process (Williams-Crowe & Aultman, 1994, p.361). Once the bill has been signed by the President, budget committees prepare spending estimates for its implementation in the upcoming financial year. This process involves setting funding levels in Appropriations bill and authorization to establish funding levels for particular programs.

Implementation Stage

Similar to the legislative stage, the implementation process requires concerted efforts by the federal, state, and local governments. The implementation stage is the process where information about the adopted policy is disseminated and the policy is put into action (Abood, 2007). This implies that this stage involves the transformation of the adopted policy into a plan of action. Since it is a federal policy, the public health policy regarding health workers shortage will be implemented through a regulatory process in which the law is translated into a written set of rules issued by the government agency with the responsibility for administering the policy.