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   Part G. Implementing Promising Community Interventions
      Chapter 25. Changing Policies >
         Section 1. Changing Policies: An Overview >
             Examples - Real world situational examples. >

Changing Policies: An Overview

  

Examples

 Contributed by Phil Rabinowitz Edited by Bill Berkowitz

 

Example: Achieving Regulatory Change

by Val Renault

 

Sometimes “Plan B” works best for making positive policy change.

 

If you determine that introducing legislation is not practical or not likely to succeed, consider seeking a change in practice or regulations.  While this type of change is often a compromise, it can accomplish the desired goals more quickly than attempting to pass or amend a bill.

 

In Kansas, a coalition of groups and individuals working to improve children’s health wanted to introduce a bill that required screening all children in public schools for respiratory illness, a process similar to the screenings that are conducted for vision and hearing.  Asthma causes more lost school days and pediatric emergency room visits than any other chronic disease in the U.S., so the supporters felt their case for screening was strong.

 

But the Kansas Asthma Coalition members also realized that unfunded mandates are not popular, so they took a different strategy. They proposed that the state add these four “yes/no” questions to the school health assessment form that is used by Social and Rehabilitation Services (SRS):

 

1)      Has your child ever been diagnosed by a doctor as having asthma?

2)      Has your child ever been prescribed an inhaler?

3)      Has your child had an episode of wheezing in the last 12 months?

4)      In the last 12 months have you heard your child wheeze or cough after running or crying?

 

The questions are a meaningful addition to the health form because they screen for children with asthma, whose records can then be flagged to alert school nurses and other school staff to the need for preventing asthma attacks. In addition, the questions did not create any new expenses or require new training and processes for the people who conduct the screening.

 

The advisory board that was responsible for making such decisions approved adding the questions to the health form. While this change in regulatory practice is not as far-reaching as a statewide law for screening, it is progress toward a system-wide improvement in preventive health care for children with asthma.

 

This example also illustrates the fact that it usually takes a collaboration to make policy change. The Policy Committee of the Kansas Asthma Coalition drove this effort to improve care for children with asthma. The coalition included concerned physicians, along with representatives of the American Lung Association of Kansas and the Kansas Department of Health and Education.

 

Coalition member Judy Keller, executive director of the Lung Association of Kansas, summarizes the steps included in making this type of policy change:

 

  • Collect and analyze data.
  • Bring various stakeholders together to form a coalition to help in the process as early as possible.
  • Determine whether change is needed and how that change will take place.
  • Enlist support.
  • Implement change.
  • Evaluate.
  • Revise.
  • Work for continuous improvement as related to the coalition’s mission.

 

 

References

 

http://www.apa.org/monitor/oct00/policy.html

http://www.ids.ac.uk/gdn/tools/influence.htm