A. Community Oral Health Policy
2. Stages of Policy Development
U.S. policy development encompasses several stages.
Most policy models include the following stages: (1) a statement
of the
issue to be addressed by the proposed policy as defined by
the analyst, (2) placement on the agenda, (3) formulation
of the policy, (4) implementation of the policy, and (5) evaluation
of the policy.
The first step in developing policy that affects
oral health involves determining the current status of oral health
outcomes,
policies,
and opinions. This is followed by agenda placement, which involves
drawing the attention of a range of audiences—the general
public, the media, and decision-makers—to the issues.
Conducting an oral health needs and resources assessment can
play a critical
role in gaining the attention of these audiences. Audiences
must be concerned about a problem before they become interested
in developing
policy solutions. Community oral health stakeholders can also
contribute to the policy process at this stage by crafting
policies designed
to address identified needs. For example, to address children’s
lack of access to oral health services, a policy to include
oral health services as an SCHIP benefit could be offered as
a policy
solution.
Identifying the legislative, regulatory, judicial,
or other institution responsible for policy adoption and
formulation is the next stage
in the policy process. Again, oral health stakeholders can
provide expert guidance, offering both scientific expertise
and hands-on
community experience. Once a policy is established, it is
up to those in the field to implement it. Since oral health professionals
and their partners know their communities, they are in an
ideal
position to collaborate with state and city/county agencies
in the implementation of policies to improve oral health
status. Finally,
implementing a policy to address particular issues does not
necessarily
ensure that the issue will be successfully addressed. The
policy and its effects must be evaluated against what the policy
was
designed to accomplish. Those working in community oral health
programs
and their colleagues are often well positioned to contribute
to evaluations of the impact of policy changes. They can
also help
to mobilize and nurture ongoing community support for policies
and programs to improve oral health status.
It is important to understand what policy-related
oral health activities are permissible within the context of
a program’s mission,
role, and source of financial support. While it is the responsibility
of health professionals to inform, educate, and advocate for oral
health, it is important to be cautious about the line between education
and lobbying.
It is also essential to recognize that when programs
are funded through tax dollars, there are restrictions on the
use of these
dollars to influence legislation. In general, taxpayer funds
cannot be used to support lobbying of lawmaking bodies. However,
it is
legal for government employees to speak to their elected representatives
on their own time. Agency policy is an important resource when
dealing with these issues. Another source of information is the
U.S.
Department of Internal Revenue which provides concrete
guidelines on political and lobbying activities.
|