The Art and

Science of Policy-
Making
Chapter 6

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Introduction

• The purpose of public policy is to fashion

strategies for solving public problems
• Regarding nutrition, the strategies for solving
problems typically include:
• Food and nutrition assistance programs
• Dietary recommendations
• Reimbursement mechanisms for nutrition services
• Public policy is complex and ever-changing

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Policymaking

• Policy – course of action chosen by public

authorities to address a given problem
• Problem – “substantial discrepancy between what
is and what should be”
• Policymaking – process by which authorities
decide what actions to take to address a problem
or set of problems

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Policymaking (cont’d.)

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The Policy Cycle

1. Problem definition and agenda setting

• Convince other people that a public problem exists
• Bring together a broad-based grassroots constituency
that supports addressing the problem
• This begins the agenda setting process
• Gain and seek support from administrators and
policymakers
• Have the problem placed on the institutional agenda

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The Policy Cycle (cont’d.)

• A photo can bring an urgent issue to the public’s

attention

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The Policy Cycle (cont’d.)

2. Formulation of alternatives
• Interest groups, coalitions, networks of experts, and
“grassroots” individuals interested in the problem can be
asked to help with designing alternatives to be
presented to policy makers
• A key consideration is whether the best proposed
solution is reasonable
• In the U.S., policy is formulated by the legislative,
executive, and judicial branches of the government at
the national, state, and local levels

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The Policy Cycle (cont’d.)

3. Policy adoption
• Tools and instruments are selected to achieve the policy
goal
• Regulations, funding, tax breaks, government-
sponsored programs
• Policy adoption can occur on a local, state, or national
level
• At the federal level – the Department of Health and
Human Services (DHHS) and the U.S. Department of
Agriculture (USDA)

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DHHS Org Chart

https://www.hhs.gov/about/agencies/orgchart/index.html
USDA Org Chart

https://www.usda.gov/sites/default/files/documents/usda-
organization-chart.pdf
The Policy Cycle (cont’d.)

4. Policy implementation
• Implementation is the process of putting the policy into
action after necessary modifications have been made
for the target clientele
• May involve a large number of people and
organizations to carry out the process

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The Policy Cycle (cont’d.)

5. Policy evaluation
• The purpose of policy evaluation is to determine:
• Whether the program developed to support the policy
is achieving its goals
• If program is reaching its intended audience
• What the program is actually accomplishing
• Who is benefiting from it
• Ideally, public policies should be evaluated after they
have been implemented
• Use best research methods available

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The Policy Cycle (cont’d.)

6. Policy termination
• Reasons for termination include:
• The public need was met
• The nature of the problem changed
• Government no longer had a mandate in the area
• The policy lost political support
• Private agencies relieved the need
• A political system or subgovernment ceased to
function
• The policy was too costly

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The People Who Make Policy

• An organization’s or committee’s executives,

administrators, committees
• Elected officials
• Employees of municipal, state or federal agencies
• Members of Congress and state legislators
• Street-level bureaucrats
• Community nutritionists

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Levels of Govt Involvement

Implementation of NSLP
Policy Making and
Federal: Set procurement and
minimum standard guidelines if
using federal dollars

State: Can encourage local

purchasing according to federal
guidelines

Local: Can set district or school

menus and make purchasing
decisions within guidelines
Legitimizing Policy

• A choice must be made on how the policy is

implemented
• Must have willingness of citizens that the
government has the right to govern
• Legitimacy is mainly in the mind—it depends on a
majority of the population’s accepting that the
government has the right to govern

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Legitimizing Policy (cont’d.)

• Mechanisms for legitimizing policies include:

• The legislative process
• The regulatory process
• The court system
• Various procedures for direct democracy, such as
referenda, which put sensitive issues directly before the
people

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The Legislative and Regulatory
Process
• Laws are a unique tool of government used to
influence the lives of citizens
• Congress sets policy and supplies the basic
legislation that governs our lives

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Laws and Regulations

• Laws passed by Congress tend to be vague

• Define the broad scope of the policy
• Administrative bodies must interpret the law and
provide detailed regulations
• “Secondary legislation”

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How an Idea Becomes Law

• https://www.youtube.com/watch?v=OgVKvqTItto
• A concerned citizen, group, or organization brings
an issue to the attention of a legislative
representative at the local, state, or national level
• The bill is written and submitted to the clerk where
it is numbered and printed
• The bill must be sponsored by at least one
legislative member (House or Senate, or both)
• The bill is referred to committee and subcommittee
• The greatest challenge is getting out with a favorable
vote
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How an Idea Becomes Law (cont’d.)

• Markup sessions by subcommittee and committee

revise the original bill
• The committee votes on whether to send the bill
forward with a favorable vote or table it
• Approved bills go before the full membership for
debate, amendment, and vote

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How an Idea Becomes Law (cont’d.)

• If the bill passes, it goes to the other body of

legislature or Congress for the same actions
• Finished versions of the bill will probably differ
between bodies, so a conference committee
meets to resolve differences
• The modified bill that is agreed upon is sent to the
President (governor) for action

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How an Idea Becomes Law (cont’d.)

• Sign into law by the president

• Veto and return to legislature (Congress) –
requires a two-thirds vote by each house to
override
• No action while in session – automatically
becomes law

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How a Bill Becomes a Law

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Typical Opportunities for Input in the
Legislative Process

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Typical Opportunities for Input in the
Legislative Process (cont’d.)

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Enactment

• Law is referred to appropriate agency responsible

for issuing guidelines or regulations
• Publication of proposed guidelines – mandatory
comment period of 30–120 days for public
response
• At the end of the comment period, the agency
reviews all comments before issuing its final
regulations
• These are incorporated into the Code of Federal
Regulations (CFR)

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Federal Budget Process

• Congress must enact bills to fund the programs

and services mandated by federal legislation
• The budget process has two stages:
• The president proposes a budget
• Congress reacts to the president’s proposal

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Federal Budget Process (cont’d.)

• The budget is the president’s financial plan for the

federal government
• Receipts or revenue – amounts raised through taxes
and fees
• Budget authority – amounts that agencies are allowed
to spend in implementing their programs
• Budget outlays – amounts actually paid out by
government agencies

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Federal Budget Process (cont’d.)

• There are two types of spending

• Mandatory spending for entitlements
• Entitlements are programs that require payments to
anyone who is eligible
• Discretionary spending
• Spending choices that can be made in areas such as
defense, energy assistance, nutrition assistance
• The federal fiscal year begins on October 1 and
runs through September 30 of the following year

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https://www.cbpp.org/research/video-policy-basics-where-do-our-
federal-tax-dollars-go
Federal Budget Process (cont’d.)

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Federal Budget Process (cont’d.)

• Budget authorization establishes programs

• Defines scope of programs
• Sets a ceiling on spending
• Does not provide money
• Budget appropriation provides money for
programs
• The appropriation may cover a single year, several
years, or an indefinite period of time

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Federal Budget Process (cont’d.)

• All revenue and appropriations bills passed by the

House are forwarded to the Senate for
consideration
• Differences between the two houses are worked
out in conference committee
• Ultimately a reconciliation bill is passed
• Congress adopts its version of the budget in a
budget resolution
• If unable to pass a budget by the beginning of the fiscal
year, Congress may adopt continuing resolutions

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The Political Process

• The complexities of the legislative and

policymaking process present many challenges
• Years may be required to reach a critical mass in
public support for a policy change
• Examples include passage of the Food and Drugs Act
and more recently, the Medicare Medical Nutrition
Therapy Act

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The Political Process (cont’d.)

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Current Legislation and Emerging
Policy Issues
• Current legislation and emerging issues have the
potential to affect:
• The delivery of food and nutrition programs
• The way in which community nutritionists work
• The Academy of Nutrition and Dietetics is currently
addressing the following three priority areas:
• Disease prevention and treatment
• Life-cycle nutrition
• Quality health care

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Current Legislation and Emerging
Policy Issues (cont’d.)
• State licensure laws
• Licensure is designed to help the general public identify
individuals qualified by training, experience, and testing
to provide nutrition information and medical nutrition
therapy
• Currently 48 states with statutory provisions for practice
• Bioterrorism and food safety
• Food safety refers to foods free of foodborne pathogens
and a food supply free of contamination via bioterrorism

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Current Legislation and Emerging
Policy Issues (cont’d.)
• Biotechnology
• Today, biotechnology has many applications in the
dairy, baking, meat, enzyme, and fermentation
industries
• Sustainable food systems and public health
• The involvement of public health professionals in food
and agricultural policy provides many opportunities for
advancing the public’s health

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Current Legislation and Emerging
Policy Issues (cont’d.)
• Complementary and alternative medicine (CAM)
• In North America, CAM has emerged more recently as a
potential adjunct approach to traditional Western
medicine
• Functional foods and nutraceuticals in the
mainstream
• Functional foods—foods that may provide health
benefits beyond basic nutrition

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Current Legislation and Emerging
Policy Issues (cont’d.)
• The growing dietary and herbal supplement
markets
• These continue to grow despite minimal government
oversight and a profusion of questions regarding the
quality and reliability of the products available in today’s
marketplace
• The human genome and genetic screening
• Advances in genetics research have identified more
than 1,400 disease-associated genes

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The Community Nutritionist in Action

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The Community Nutritionist in Action
(cont’d.)
• Make your opinion known
• Present ideas at public meetings
• Write letters to newspaper, magazine, or journal editors
• Make telephone calls or send emails to elected officials
• Conduct a public forum on an issue
• Become directly involved
• Run for political office
• Collect signatures for a petition to send to legislature

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The Community Nutritionist in Action
(cont’d.)
• Join an interest group
• Trade associations
• Professional organizations
• Public interest groups
• Class action suits
• Public relations campaign

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Taking Political Action

• Write effective letters

• Make effective telephone calls
• Use e-mail effectively
• Work with the media

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Political Realities

• “Never doubt that a small group of thoughtful,

committed citizens can change the world; indeed,
it’s the only thing that ever has” —Margaret Mead
• You can make a difference in your community by:
• Understanding the policymaking process
• Taking time to express your opinion
• Being persistent and patient

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