Policy Advice System for Hhs

Policy Advice System for HHS

The Department of Health and Human Services is the principle agency for protecting the health of all Americans and providing essential human services especially for those who are least able to help themselves (HHS Website). Our role and our organization are central to all aspects of social policy in the United States and our budget accounts for ј of the entire federal outlays. Therefore, I am honored that you requested my assistance in creating a new policy advice system. Though the scope of our activities is daunting, I assure you that there are principles and precedents in policy analysis and decision making that make this a surmountable task.

In describing a policy advice system, we must first identify its structure and how that fits into the structure of our organization. I envision it in three levels, the directorate or agency level, the departmental policy staff level, and then an executive council (EC) level. Much of the policy research and staff analysis infrastructure is already in place. Each of our subordinate departments and agencies has their own policy advisors or staffs that conduct policy analysis at their level. Empower some of our policy staffs and analyst at the agency level will help ensure that we get analysis that is closer to ground truth and not too distant (Meltsner, 1976). It is important that you provide general advice and guidance to these subordinate staffs concerning policy analysis as well as to the department's policy staff. This memo will provide much of that advice and guidance especially in discussing the role of analysis, best practices and the use of statistics. The second level, the departmental policy staff, run by the Assistant Secretary for Planning and Evaluation, will also adhere to that advice, but must further be instructed to take a broader view, consider more alternative approaches (to avoid being caught in narrow solutions (Meltsner, 1976)), look closely at history, and serve the primary function of providing your EC with the information it needs to assist you in making and forming final decisions. The EC will be comprised of your Assistant Secretaries and any other close advisors or outside expertise that you deem necessary, based upon what particular piece of policy you are reviewing. The EC should meet regularly for routine policy reviews and be ready to meet for crisis situations. I would caution you to keep it small and select the individuals from whom you will take your closest and most trusted advice very carefully (Neustadt and May, 1986). When placing individuals on the EC and taking their advice, you should always consider their background and set yourself in their shoes to determine (1) if they should be on the EC for that issue, and (2) how their background might affect their advice. They will be responsible for considering the reaction of other stakeholders, 2nd and 3rd order effects of decisions, and most importantly helping you put proper historical perspective on your decisions. They too must understand the policy advice and guidance I will describe.

Policy researchers and analysts at all levels have a very important role to play. They are often the ones who set about defining the problem. We must make sure that we give appropriate guidance to the departmental policy level so they can in turn keep the agency level staffs in line and on target. All policy analysts should keep in mind that defining a problem means that we assume that it has a solution and but we should not jump too quickly to a particular solution or implicitly favor a solution in the way we define a problem (Bardach, 2001). The definition should also lend itself to things that are quantifiable as these will help in setting measurements and determining attainable goals.

We must also evaluate our own activities, correcting errors as we go along and acknowledging mistakes in order to improve our performance and our policies (Wildavsky, 1987). In doing so we must remember that as a government organization, we will always be better at dispersing money, than we will be at changing people's behavior. Much of our issues concerning health are very directly affected by people's behavior. Therefore, we must recognize our limitations and not attempt to over spend and over solve problems that in the end come down to personal choice. We can only do so much. With this in mind, we must also realize that our problems and solutions are often the result of previous solutions implemented to other problems. Therefore, we must first be aware of this, and then be cognizant of the 2nd and 3rd order effects of the solutions we recommend both on our department and the country as a whole. Policy analysis is itself a system that interacts with other systems.

Our analysts at all levels need to remember that policy analysis is both an art and a science. It sets out to do several things (Wildavsky, 1987). It must explain how the problem came about, it must describe what can be done and then what should be done. (i.e. descriptive, prescriptive, selective.) It must take into account the past, harness creativity of our analysts in the search for solutions, and it must look carefully at how solutions could affect the future (retrospective, inventive, prospective). It must also take into account the stakeholders and the individual interests of all involved because, try as we might, we can never completely separate politics from policy. Politics is the art of the possible, and solutions that are not within the realm of the possible are of no interest to us. Yet, we must also be disciplined in our use of evidence and quantification (both subjective and objective). With that in mind, our analysts at all levels should avoid recommending change for its own sake (sometimes the status quo is the best solution) and remember that if recommendations are not timely, then the are useless (Meltsner, 1976).

In order to keep our agency level policy shops in check, our departmental policy staff will be instrumental in defining problems and then issuing guidance for how those problems are to be studied. Sometimes that will mean delegating the study or part of a study to an agency as appropriate, sometimes it will mean that the departmental staff takes on the study, sometimes it will involve both. Once this is decided, our analysts should generally follow the eightfold path (Bardach, 2000). Beginning with defining the problem, the steps in this path are (2) assemble evidence, (3) construct alternatives, (4) select criteria, (5) project outcomes, (6) confront trade-offs, (7) decide, (8) communicate the policy and the decision. Our departmental policy staff should adhere to this approach for everything that comes before you or through the EC for decision. Ultimately, the "decide" part will be up to you with