The Legislative Process #415

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Policy Enactment: Legislation and Politics

CHAPTER 5

Introduction

Structure of governments

Engagement of nurses in politics at all levels

Expectations of the public

Structure of the Federal Government

Constitutional republic

Democratically elected leaders

Separation of powers between the federal and state governments

Three branches

Executive

Legislative

Judicial

The Executive Branch

Consists of:

President

Vice president

Executive Office of the President

Presidential cabinet members

Powers of the president

Oversees military

Signs legislation into law

Can create executive orders

Can veto bills from Congress

This branch has shared responsibility for federal agencies with legislative branch.

The Legislative Branch

Consists of Congress

House of Representatives

Senate

Congressional committees

Nurses can monitor committees for significant federal legislation and work with professional organizations to influence policymakers on the issues.

The Judicial Branch

Consists of:

Supreme Court

Courts of Appeals

District Courts

Bankruptcy Courts

Article I Courts

Resolves disputes about the U.S. Constitution and other federal laws

Structure of State and Local Governments

Three branches

Executive

Legislative

Judicial

Similar to federal branches but structures may not be identical

Legislation

Nurses can present issues or ideas to solve a problem to legislators.

Legislators then draft a bill and introduce it to Congress.

After the bill is introduced, the following take place:

Debate and review

Amendment

Vote by both chambers

Committees

Congress members are voted into leadership positions by their peers.

The majority party leadership selects committee chairs for the session.

The minority party selects leaders called ranking members.

Committees vote to accept or reject bills after reviewing them.

If accepted, the bill goes to the floor of the House or Senate and is voted on again.

If the bill passes both chambers of Congress, it is sent to the chief executive.

Federal: president

State: governor

The chief executive either signs or vetoes the bill.

Funding Legislation: Winning a Seat at the Table

Raising campaign funds

Individuals

Special interest groups: 527 organizations and Political Action Committees (PACs)

Campaign finance law

Citizens United v. Federal Election Commission

Influences That Affect Decisions in the Policy Arena

The People: Legislators and Legislative Staff

Legislators (lawmakers)

Chief of staff

Administrative assistants

Legislative directors—responsible for day-to-day legislative activities

Press secretary—responsible for press releases and public relations

Legislative assistants/aides (LAs)—multiple areas of responsibility

Committee staff—support work of congressional committees

The People: Constituents

Engaging constituents/voters to support an issue is an important way to gain momentum.

Nursing groups have succeeded in advancing legislation by creating coalitions that include stakeholders from various perspectives and voting blocks.

The People: Special Interest Groups

Lobbyists

Often hired by special interest groups

Must follow established guidelines if professional lobbyists

Special interest groups

Stakeholders attempting to gain influence on an issue

Types of special interest groups

Political action committees (PACs)

527 organizations

Registered nurses constitute a special interest group

Political Strategy

Success in influencing health policy requires knowledge of:

Political environment

Political players

Political climate

Strategy includes knowing:

When to strike

Which stakeholders will have the most impact

Who can and will work together

What the opposition’s strengths and weaknesses are

Funding of efforts to get legislation passed

Approaches for nurses

Communicating directly with legislators

Working with political advisers

Nurses Engaged in Legislative Policy Change

Federal level

Common areas of focus

Nursing Workforce Development programs of Title VIII of the Public Health Service Act and its amendments in the Nursing Reauthorization Act

State level

Common areas of focus

Scope of practice issues

Conclusion

Build relationships with legislators, legislative staff, policy experts, and key stakeholders.

Understand that change is often incremental and takes time.

Look for common ground and measures that will appeal to both sides of the aisle.

Think politically, use strategy to develop a plan, and play the political game.

The Legislative Process #415

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