SAMI TEAM
LEGISLATOR, POLICY MAKER
Policymakers are those individuals who develop policies and procedures for funding and delivering services to persons in need. Policymakers can be found within the public, nonprofit, and private sectors of society. They are elected and appointed officials in branches of county, state, and federal government. They are also executives and board members of publicly funded service agencies and nonprofit and for-profit service agencies. The policies that govern the delivery of integrated substance abuse and mental health services exist as agency protocol and as federal and state law. Below is a list of the policymakers who are typically involved with health and human service policies:
Federal Government
- Legislators (Representatives and Senators)
- Executives and administrators of federal agencies (e.g., the National Institute of Mental Health (NIMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA))
State Government
- Legislators (Representatives and Senators)
- Executives and administrators of state agencies (e.g., the Ohio Department of Mental Health (ODMH) and the Ohio Department of Alcohol and Drug Addiction Services (ODADAS)
County Government
- Commissioners
- Executives and administrators of mental health and alcohol-and-drug-addiction services boards
Foundations
- Executives
- Program officers
Service Agencies
- Administrators and executives
- Members of governing and advisory boards
ADVOCATES
The following individuals and groups may be involved in the process of advocating for change in policies and service strategies for the delivery of integrated substance abuse and mental health services:
- Consumers
- Family Caregivers
- Service professionals (e.g., direct service providers, supervisors, agency administrators)
- Individual agencies or consortia of agencies
- County boards and their state-wide association
- State-level mental health and substance abuse service agencies
- Consortia of state-level mental health and substance abuse service agencies
- Local and regional advocacy groups (e.g., National
Alliance for the Mentally Ill of Ohio and local affiliates; Ohio Advocates
for Mental Health)
- National advocacy and lobby groups (e.g., National Alliance for the Mentally Ill)
SERVICE PROFESSIONALS
SAMI team members often play an active role in shaping and reshaping the policies of service agencies by identifying service needs in their communities and reporting those needs to their supervisors. These needs may include the availability and accessibility of safe housing, mobile crisis services, affordable medical care, and support groups like dual recovery anonymous, among others. SAMI team members also play an active role in identifying the barriers that inhibit efficient and effective service delivery. Barriers may include policies and laws that govern billing, record keeping, confidentiality, and consumer employment, among others.
ADVOCACY PROCESS
SAMI team members and Steering Commitee members
are among the best equipped to identify service needs and barriers to care
because they work closely with consumers and families. Service professionals
advocate on behalf of consumers and families to their supervisors, who advance
the process of advocacy beyond the agency. Advocacy typically occurs through
the following process:
- Service professionals report service needs to agency supervisors.
- Supervisors advocate to agency executives and agency board members.
- Agency executives and board members work with representatives from other agencies and advocacy groups through committees, consortia, and initiatives to advocate to county-level boards and state-level mental health and substance abuse agencies.
- State-level mental health and substance abuse service agencies and advocacy groups work with state legislators.
- Consortia of state-level mental health and substance abuse service agencies and advocacy groups work with federal agencies and legislators.
Although advocating for service innovations and policy innovations appears to be a linear process, it is not. The inspiration for change may come from any one of the groups mentioned above--from a top-down (legislative) initiative, a bottom-up (grassroots or community-based) initiative, or from top-down and bottom-up initiatives that occur simultaneously. No matter how the innovations begin, though, they typically originate with information conveyed from consumers, caregivers, and service professionals. This is why it is important to document as many real-life stories as possible. These stories often function as evidence that helps persuade policymakers to enact change.
PUBLIC -POLICY PROCESS
The process of approaching and influencing public policymakers--such as county commissioners, state legislators, and federal legislators--can be complex. Many individuals and groups may be involved in the process. Agency executives and directors may learn how to become involved by contacting their county and state mental health or substance abuse services board. In Ohio, agency executives and directors may contact ODMH and ODADAS (see Resources section below). The following is a general outline of the public policy-making process.
Identify the Problem
The task in this first stage is to articulate a comprehensive definition of the problem that needs to be addressed from as many perspectives as possible, including those of consumers, family caregivers, service professionals, agency administrators, and county, state, and federal executives, administrators, and legislators, among others. A clear and comprehensive definition of the problem helps formulate a clear and comprehensive plan of action. The following are important questions to ask in this stage of the policy-making process:
- What is the problem?
- Do different groups define the problem differently?
- Do different groups differ in their abilities to get their interests/views acknowledged?
- What is known about the causes and consequences of the problem?
Formulate a Plan
The task in this stage is to develop a clear and
comprehensive plan to address the problem and to get decision makers, legislators,
and other policymakers to cast their votes to convert the plan, or portions
of the plan, into law/action. A plan will identify the problem with statistics
and stories about a number of effects, such as the financial, emotional,
legal, and medical costs associated with the problem. The plan will include
information about service strategies, programs, policies, and laws that
have been developed elsewhere to address a similar problem, as well as statistics
and stories about successes. The plan will also include descriptions of
laws or other actions that should be enacted and service strategies, programs,
and policies that should be supported. The following are important questions
to ask in this stage of the policymaking process:
- Who are the key actors in the formulation stage?
- Where does formulation take place? (i.e., county boards, regional or national associations, or the executive, legislative, or judicial branches of state or federal government)
- With which individuals, agencies, and groups should we form partnerships to develop, present, and implement the plan?
Implement a Program
Once a law has been enacted or a policy statement has been issued by a county, state, or federal agency, the tasks shift from planning and persuasion to implementation. In this stage, procedures, rules, and regulations are developed to transform policies into service innovations and program implementation strategies. The implementation of change often requires the continual review and modification of the new strategies, which takes time. During this stage, individuals need to be patient and persistent to ensure that the best possible solutions are implemented. For an overview of some common steps that are taken in the development of integrated services for co-occurring disorders, click on the words program consultation in the header of this page. The following are important questions to ask in this stage of the policymaking process:
- Who are the key actors in the implementation stage?
- What potential problems might arise?
Evaluate Outcomes
The task in this stage is to gather information that will enable public policymakers and agency policymakers to judge how well a policy is working. Other individuals and groups that are typically interested in evaluation results include consumers, foundations (and other funders), and national associations. Evaluation and research efforts can identify strengths and weaknesses in the organization and administration of services and, therefore, equip policymakers with the information they need to make adjustments in laws, policies, and procedures. Often, the success of policies depends upon the ability of policymakers to make fast, informed decisions that will produce positive results. This information is most commonly obtained from evaluations, which may take the form of government hearings and research studies that analyze service outcomes and consumer and family-caregiver satisfaction. For an explanation of the role of research and evaluation in integrated services for dual disorders, click on the words research and evaluation in the header of this page.
CONTRIBUTORS
This section of the Ohio SAMI CCOE was written with contributions from the following:
Eric Poklar, Legislative Liaison
Ohio Department of Mental Health (ODMH)
RESOURCES
Ohio Department of Mental Health (ODMH)
Legislative Liaison
30 East Broad St 8th floor
Columbus, Ohio 43215
614.644.6791
Ohio Department of Alcohol and Drug Addiction Services (ODADAS)
Legislative Liaison
Two Nationwide Plaza
280 North High Street, 12TH Floor
Columbus, Ohio 43215
614.752.8359
State of Ohio
Administrative, Judicial, & Legislative Branches
www.state.oh.us/government.htm
United States House of Representatives (Legislative Branch)
www.house.gov/
United States Senate (Legislative Branch)
www.senate.gov/
The White House (U.S. Executive Branch)
www.whitehouse.gov/
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