Healthcare policy course

Stakeholders vs Policymakers Edson College of Nursing and Health Innovation By Lori J Lustig, JD BSN Spring 2021 Where Policy is made 2 Public Sources – • Executive – President by Executive Order • Federal/Congressional – Congress by legislation • State/Legislative – Legislature by legislation • Local/Municipal (Counties, Cites & Towns) by adoption of ordinances • Agency/Regulatory – Agencies through rulemaking Organizational Sources – • For Profit – Board of Directors and Executive Leadership by company policy • Not for Profit – Board of Directors by internal policy, mission statement Professional Sources – • Individual – AMA, ANA, ACOG • Corporate Member – AHA, PhRMA (Brinkman, January 2018) What is Policymaking? 3 Policymaking is the act of creating institutional or governmental guidelines by which an entity or population operates.

Policies are those guidelines which are created, amended or institutionalized.

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Policymaking is one process by which to innovate in healthcare. Who are the Policymakers – Examples 4 Public Sector  President -Executive  US Representatives and US Senators -Legislative  Governors -Executive  State Legislators -Legislative  Mayors, Supervisors, Council Members –Executive/Legislative  Agencies –Federal and State –Regulatory  Judiciary –The Judicial Branch is NOT a policymaker. The Judicial Branch is a check against unconstitutional policy and policymaking. Traditional view: It does not create policy by upholding or striking down a particular policy.

Today, there are two competing views -Judicial Activism vs Judicial Restraint . Who are the Policymakers (cont’d) 5 Institutional/Organizational  Board of Directors  C Suite (President, CEO, CFO, CME, DON, etc.)  Departmental Directors  Staff (Porche , 2019) Perspective – which will you choose for your policy project? 6 Government sector:

• Executive Branch –President, Governors, Mayors/Councils • Agencies: Federal/State -FDA (regulatory), CMS (payment deliverables), FEMA (procurement/infrastructure ) Corporate sector:

• Manufacturers -medical technology. PPE • Retail/Big Box Stores –testing sites, supply chain • Pharmaceutical Companies –off -label use and new treatment modalities • Insurance –coverage and waivers Small Business sector:

• Restaurants/deliveries • Clothing/Face masks • Breweries/Hand sanitizer The Public sector –you the individual Who’s against your policy? Who’s for it ? These are the STAKEHOLDERS – anyone affected by the policy and who has a stake in its passage or defeat. 7 STAKEHOLDERS are those groups or entities –or your boss at work -who can help support your idea, or can effectively kill it. They are positively or negatively affected by it. If you don’t know who they are, you are missing a huge piece in your policymaking effort. Identify them! STAKEHOLDERS are invited to the table to negotiate and work on the policy idea. But you cannot invite a generic group. Find specific stakeholders –they may already have a position on your proposed idea. Stakeholders (examples – generic and specific) 8 Chambers of Commerce (Generic)  US Chamber of Commerce, State/Local Chambers of Commerce (AZ, Phoenix) (sp ) Trade Associations –By Industry (Generic)  AHA, APA, AHIP, PhRMA (Specific) Professional Associations –By Profession (Generic)  AMA, ANA, ACOG, Assoc. of Trial Lawyers of America (ATLA ) (Specific) Public Interest Groups –Associations and Public Activist Groups (Generic)  AARP, Alzheimer’s Association, Nat’l Alliance on Mental Illness (NAMI ) (Specific) Regulatory Agencies -responsible for implementation/oversight (Generic)  FDA, CMS, DHS, AHCCCS, AZDES (Specific) When the assignment calls for identification of Stakeholders: Broad categories or specific participants? 9 • You cannot engage in successful policymaking unless you have identified those participants who will support or oppose your policy. You cannot invite a broad category to the negotiating table/meeting . • Always identify the specific participants for full credit . Even if you mention the broader category (opponent/proponent) pertinent to your policy to set the stage –make sure to identify those you will need to negotiate/collaborate with to assist you in your effort, or to find common ground with to eliminate opposition to your policy. It can be a national group, corporate powerhouse, or your supervisor. The first question a legislator will ask when bringing a policy idea to them for sponsorship –“Who’s against the bill?” • If you don’t know your allies/opponents, you cannot succeed on the policymaking playing field. • Don’t ever assume the opposition won’t hear about your policy and that you have no opposition. Last minute objectors are never a good omen. References 10 Brinkman , J.T. (January, 2018) Healthcare Policy: Where it comes from and how to change it. The O&P Edge . Porche , D. J. (2019). Health Policy: Application for Nurses and Other Healthcare Professionals. Burlington , MA: Jones and Bartlett Learning SlidesCarnival . (2019). Free powerpoint templates. Retrieved from https:// -templates/page/8

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