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REPORT OF THE
Advisory Committee for Health Policy
in the School of Public Health and
Community Medicine
1
Introduction: The IOM Challenge
In 2003, the Institute of Medicine (IOM) asked the nation, “Who will keep the public
healthy?” (IOM, 2003). The IOM noted the new and accelerating challenges to the public‟s
health, and charged schools of public health with evolving “in part because current problems
demand new knowledge and approaches, and in part because of scientific advances and the
increased understanding of the determinants of health, their linkages, and their interactions”
(IOM, p. 108). Noting the many disciplines represented by faculty in schools of public health,
the IOM asserted that these schools are “uniquely poised to embrace the transdisciplinary
approach to education and research that is necessary for an ecological focus” (IOM, p. 108).
The IOM charged schools of public health with six major responsibilities:
1). Educate the educators, practitioners, and researchers, and prepare public health
leaders and managers;
2). Serve as a focal point for multi-school transdisciplinary research as well as traditional
public health research to improve the health of the public;
3). Contribute to policy that advances the health of the public;
4). Work collaboratively with other professional schools to assure quality public health
content in their programs;
5). Assure access to life-long learning for the public health workforce; and
6). Actively engage with various communities to improve the public‟s health.
Throughout the report, the IOM underscored the
centrality of politics, policy development, and policy SCHOOLS OF PUBLIC
analysis to improvements in the public‟s health. HEALTH PLAY A PRIMARY. .
ROLE IN HEALTH POLICY
In January, 2004, Dean Pat Wahl created a DEVELOPMENT AND
multidisciplinary committee to examine how the University DISSEMINATION. IOM, p.4
of Washington‟s School of Public Health and Community
Medicine should respond to the IOM‟s call to action in the area of health policy. This report
summarizes the deliberations of that committee over the 7 months of its deliberation.
The Dean‟s Charge
The Dean‟s overall charge, in keeping with the IOM‟s recommendations, recognized that
the SPHCM has a multi-faceted role to play in improving public health policy. The Dean asked
the Committee to:
1). Develop a five-year strategic plan for building greater health policy content
throughout the SPHCM, coupled with a realistic implementation plan, recognizing that over 80%
of SPHCM‟s funding comes from grants and contracts. The strategic plan should address
SPHCM‟s involvement in all four legs of the health policy stool: research, teaching, translation
and dissemination, and policy analysis. [IOM 1-6]
2
THE COMMITTEE RECOMMENDS THAT
SCHOOLS OF PUBLIC HEALTH..PLAY A
LEADERSHIP ROLE IN PUBLIC POLICY
DISCUSSIONS AND THE FUTURE OF THE With regard to research activities, the Dean
U.S. HEALTH CARE SYSTEM, INCLUDING
asked the Committee to:
ITS RELATION TO POPULATION HEALTH.
IOM p. 5
1) Determine research and funding
opportunities in health policy-related
issues relevant to the health of the public; [IOM 2, 3, 4, 5]
2) Explore the advantages of focusing our activities around one or more specific themes;
[IOM 2, 3, 4]
3) Conduct an environmental scan to identify both “customers” and competitors for this
work; and [IOM 2, 3, 4, 6]
4) Investigate the relative advantages and disadvantages of alternative structures that might
organize our initiatives; for example, a center, an institute, a resource center, or a
permanent steering committee. [IOM 2, 3, 4]
With regard to teaching, the Dean asked the Committee to:
1) Determine education and training opportunities in health policy development and
implementation for both degree-oriented students and others, including relevant professionals
in the community. [IOM 1, 5]
Two final components of the Dean‟s charge cut across the others:
1) Identify key intersections of SPHCM with other units, both on campus and in affiliated
institutions and agencies, that could be expanded to enhance health policy across the
University; and [IOM 1-6]
2) Determine the most appropriate role for the Health Policy Analysis Program within and
across each of the four areas of activity, and HPAP‟s relationship to any new structure that
might be created. [IOM 1-6]
The Dean‟s letter outlining the purpose of the Committee and its specific charge appears
in Appendix A.
The Health Policy Advisory Committee: Membership and Methods
The Committee included representatives from the Schools of Law, Pharmacy, Medicine,
Nursing, and the Evans School of Public Affairs as well as the SPHCM. A roster of Committee
members and staff appears in Appendix B.
A key function of the Committee was to identify and engage a broad range of
stakeholders: research partners (on campus and from other academic institutions and research
organizations), market partners (trade associations, industry organizations), public partners
(government decision makers), and funders (public and private). The purpose of this
“stakeholdering” was to explore the (many) strengths of the SPHCM and its partners in relation
to the burgeoning needs of the national and regional health policy community and the interests
and priorities of those who would fund our work. The Committee‟s work was informed by
presentations from its diverse membership (including a tutorial on the policy process presented
by Aaron Katz – see Appendix E); presentations by Patricia Lichiello (Acting Director of HPAP)
and Steve Smith (Professor from the Evans School of Public Affairs); site visits to eight policy
centers around the country (see Appendix C); individual interviews with Committee members
3
and other key informants (see Appendix D); a report on the health policy landscape and the
strategic opportunities it affords written by Rick Carlson, consultant to the Committee; as well as
significant exploration of web-based information. The Committee met six times from February
through July, 2004.
The Committee defined health policy as the “discipline” that systematically studies how
science, values, and decision processes combine to generate public decisions that guide
population health and health care financing and delivery. The relationship between policy
research and analysis, and policy development that guided the Committee‟s thinking appears as
Appendix E.
SIMPLY PUT, USING THE CRUDE
The outcome of the Committee‟s work was a
FORMULA THAT “SCIENCE +
set of recommendations and a 5-year strategic and POLITICS=POLICY,” DWELLING ON
implementation plan associated with the THE SCIENCE WITHOUT APPROPRIATE
recommendations regarding research and translation ATTENTION TO BOTH POLITICS AND
and dissemination. POLICY WILL NOT BE SUFFICIENT
FOR SCHOOLS TO BE SIGNIFICANT
PLAYERS IN THE FUTURE OF PUBLIC
HEALTH AND HEALTH CARE. IOM p. 4
Findings
Assessment of the internal environment
The University of Washington School of Public Health and Community Medicine is
uniquely positioned to contribute in the area of health policy. The SPHCM houses and partners
with some of the best scientists in the country: biomedical scientists including genetic medicine
specialists, geneticists, bioinformaticists, epidemiologists, biostatisticians, pathobiologists,
toxicologists, and others. SPHCM is also home to national leaders in the social sciences:
economics, law, sociology, behavioral science, program evaluation, bioethics, and others; as well
as the clinical sciences: medicine, nursing, pharmacy, and social work. The Health Policy
Analysis Program has carried the banner for applied policy research and policy analysis for 30
years, and the Department of Environmental and Occupational Health Services has a
longstanding working relationship with the Washington State Department of Labor and
Industries and the Department of Health. In the area of education and training, SPHCM‟s
Department of Health Services has a defined policy curriculum, complemented by health policy
coursework in other departments within the Health Sciences, a strong health law program in the
Gates Law School, and a top national school of public policy in the Evans School of Public
Affairs. The relatively new Ph.D. program in the Department of Health Services includes health
policy as a core competency. The Department of Health Services also houses the SPHCM‟s
growing commitment to undergraduate education in public health. The new Certificate in Health
Policy, based in Health Services but drawing upon campus-wide teaching resources, has just
become available to graduate students in SPHCM and other schools across the campus (es) (see
Appendix F). The Northwest Center for Public Health Practice and the MHA program both
sponsor non-degree training courses for mid-career health and public health professionals.
The faculty on the Committee, as well as the other faculty who were interviewed as part
of the Committee‟s work, expressed strong support for heightened and better integrated activity
in health policy. There was interest among the faculty in having assistance in creating a policy
frame around existing research and having assistance with disseminating the results of existing
4
research to decision makers. There was enthusiasm for connecting relevant research across
schools and departments, and for creating interdisciplinary teams to pursue new policy research.
The topics of interest varied expectedly among the faculty. However, the variation centered
around several major areas: biotechnology and innovation, environmental health, health
promotion, and nutrition.
Assessment of the external environment
Site Visits: Appendix C contains summary notes for each of the site visits. The sample of
institutions visited was not necessarily fully representative, but consisted of programs known
through collegial relationships and/or reputation. A balance was sought, however, across two
important dimensions: subject matter, and degrees of integration with other university schools,
departments, programs, and faculty. The subject matter included aging, mental health, genomics,
bioethics, food and nutrition, law, technology assessment, public health and health services. The
degree of integration ranged from voluntary and not university affiliated (Colorado Health
Institute), to highly integrated (School of Public Health at UC, Berkeley). Further, of the
academic institutions visited, four were within public universities and four were within private
ones. Through the site visits, the Committee found that:
1. Colleagues at the other universities were very forthcoming. All felt that UW was
particularly credible in the research and health policy fields because of its stature as a
major biomedical research institution. The reputation of the SPHCM‟s Health Policy
Analysis Program was viewed as good in those areas in which it has conducted work.
2. All felt that the timing for policy work, particularly with regard to health care reform,
public health infrastructure, and challenges such as obesity and genomics, was very good
to optimal.
3. Most, if not all, felt very strongly that the “translation” function was critical, but rarely
undertaken well.
4. Most appeared to be concerned about funding, even those with endowments (e.g. Tufts),
but none of the concerns seemed urgent.
5. All had specific sources of core funding. For some, core funds were associated with
specific multi-year research grants. For others, core funds came from endowments or
private foundation grants. A few sites had substantial state resources to undertake state
health policy work. The policy center at the University of Southern Maine was one such
center. The policy center at USM operates as part of the Muskie School of Public
Affairs, and conducts very specific projects for the state in exchange for a large ($1M)
annual budget (partly generated by Medicaid matching funds to Maine).
6. Most felt that a distinct challenge would be to identify and maintain a consistent focus
because of the multiplicity of faculty interests and project possibilities.
7. All urged significant integration with university activities, even as it was often remarked
that the bureaucracy could be daunting. The exception was the Center for Public Policy
and Genetics at Johns Hopkins. In this somewhat isolated case, this view arose from a
substantial ($9.9M) award from the PEW Foundation to found the Center, giving it
considerable latitude as to structure. Integration is not easy, particularly the integration
of the staff who work predominately on specific state health policy projects and regular
research faculty. Often interaction occurs around common data sets as opposed to
common projects.
8. All sought greater levels of collaboration with other schools, departments, programs and
faculty. None felt that enough in this respect had been accomplished.
5
9. The site that was most actively engaged in state-specific health policy work noted the
importance of building and maintaining close relationships between center staff and
decision-makers. Because this center focuses on work for a particular state agency, the
key players are relatively constant over time. Even with this advantage, maintaining
sufficient trust and visibility is very time consuming (and time specific).
Funding Sources: According to The Foundation Center‟s March, 2004 “Update on
Foundation Health Policy Grantmaking,” grant dollars targeting health policy activities more
than tripled from 1995 to 2002, to total nearly $360 million. The share of overall foundation
giving in this area rose from 1/11th in 1995 to 1/8th in 2002. The number of foundations funding
health policy activities climbed by more than half to 136, including some of the nation‟s largest.
In 2002, the top ten foundations in terms of their grants for health policy activities were: the
Robert Wood Johnson Foundation (310 grants totaling $225 M), California Endowment (45
grants totaling $31M), Pew Charitable Trusts (4 grants totaling $16 M), W. K. Kellogg
Foundation (8 grants totaling $13.5 M), John D. and Catherine T. MacArthur Foundation (11
grants totaling $11 M), the Commonwealth Fund (9 grant totaling $10 M), Rockefeller
Foundation (25 grants totaling $8 M), California Wellness Foundation (35 grants totaling $4 M),
Ford Foundation (20 grants totaling $4 M), and the David and Lucile Packard Foundation (12
grants totaling $3 M). Each of the foundations has specific policy interests and agendas; the two
California foundations restrict their giving to projects that affect the health of Californians.
Appendix G presents information on the funding interests of major foundations as they relate
to health policy research. This information was drawn from the top ten foundations that fund
health policy research and analysis; “data dumps” from the UW Central Development Office on
health care foundations, health policy foundations, a list of local foundations, and a list of health
policy grants nationwide; and our review of key funding sources of ten similar policy centers
throughout the country. Appendix G contains information on approximately 40 funding sources,
not all of which would be considered viable. The fields of information for each record include
foundation and program name, program emphasis, grant ranges, and deadlines.
Competition: Resources were not sufficient to undertake a comprehensive competitive
assessment. However, the Committee found that:
1. There is significant competition in the core field of health services research, with
many institutions chasing a large, but far from bottomless, pot of money.
2. There is specific competition in certain subject matter areas, such as food and
nutrition, public health, and genomics. In the fields of food and nutrition (particularly
obesity) and genomics, the competitors are few in number, and the funding horizons are
expanding.
3. It is clear that a significant share of federal research dollars will be allocated to topics
related to genetic services and genomics.
3. From a competitive posture, it also appears that most university-based programs are
not effectively branded, positioned and focused to be substantial performers. At least one
of the key reasons for this relative weakness is actually also a strength: the great width,
depth, and intellectual capacity at a university. The University of Pennsylvania is one of
a few universities that has focused its research strategically to great advantage.
4. Given the above, there is a real opportunity to improve on the marketing performance,
within clearly acceptable constraints.
6
5. Ultimately, of course, success against competitors has much more to do with the
quality of the work, and the commitment of the participant faculty.
A Special Note on State Health Policy
Since 1974, the SPHCM has had a strong presence in state health policy through the work
of the Health Policy Analysis Program (HPAP). While the nature of this work has evolved over
time as HPAP‟s funding (sources and amounts) and context have changed, its focus has always
been on issues relevant to near term health policy decisions in Washington State. In recent years,
HPAP‟s activities have included an annual legislative conference attended by 500-600 local and
regional policy makers and stakeholders; the Safe Table Forums that bring together smaller
groups to discuss specific policy issues, often around an HPAP-authored white paper; as well as
a wide variety of short term grant and contract-funded projects for state agencies, state-based
private groups and associations, and national foundations. The work of HPAP is recognized,
both locally and nationally, as important and of high quality. By being integrally involved in the
state health policy process and by providing information relevant to the immediate needs of state
policy makers, HPAP has created a very visible “state face” for the University and the SPHCM.
The Committee strongly believes that the UW, particularly as a public university, has an
obligation to contribute to high quality health policy decision making in Washington. The
dilemma, however, is that neither the state nor the University are able to commit the core
resources required to sustain the applied policy
THE PACE OF POLICY
analysis work over time [Note: the state has funded
DEVELOPMENT IS POORLY
MATCHED WITH THE PACE OF some core policy analysis activities at the Evergreen
SCIENTIFIC RESEARCH. IOM p. 2 State College in Olympia, although the funds are not
restricted to health policy and most of the work is in
other areas]. To be done correctly, this work requires
large amounts of time interacting with a wide range of stakeholders, building trust, learning
about issues, and changing gears as the people and issues change. As the Committee looked
around the country at other state health policy programs operating within universities that do this
type of work (see Appendix H), it discovered that all have significant sources of core support –
from state government generally, from specific state agencies, from foundations, or in
conjunction with specific research project grants (in which case the policy activities are more
narrowly defined to relate to the research project). Policy programs without such core support
focus on more traditional research and do little of the applied work.
The Committee reluctantly concluded that at this point in time, in this financial and
political context, the University‟s contribution to state health policy must be from a different
vantage point – at once both narrower and broader: narrower in the sense of fewer resources
committed to the time-intensive “on the ground” work, but broader in the sense that future UW
policy research focused on critical health policy topics, enhanced by a greater commitment of a
number of Schools and Departments within the University and complemented by the integration,
translation, and dissemination of that research, will yield findings applicable to state policy
makers. In taking this approach, the Committee understands that some opportunities are lost
(while others are gained). It further recommends that the Resource Center proposed in this
report maintain, as part of its mission, a continuing connection with the Washington State health
policy community in as many ways as are feasible (continuing the Washington Health
Legislative Conference and the Safe Table Forums are specific examples), including seeking
7
new sources of revenue to support these efforts. This recommendation is in no way a negative
reflection of the value of HPAP‟s past efforts, but simply the best course of action given current
funding realities.
Recommendations
The Committee made recommendations in two primary areas: policy research and analysis
(including dissemination of research and analysis results), and teaching and training.
Research and Policy Analysis
High quality, relevant research is not only
PUBLIC HEALTH RESEARCH what funds the bulk of SPHCM activities, it is
ANSWERS THE QUESTIONS: WHAT also what creates the most national and
ARE THE CONSEQUENCES TO HUMAN international visibility for the school. Therefore,
HEALTH OF THE WAY WE LIVE, AND
a purposeful research agenda must be at the core
WHAT CAN BE DONE TO IMPROVE IT?
IOM, p. 117 of the SPHCM‟s health policy initiative. There
are two general approaches that can make a
contribution in this area. First, we should
maximize the value of ongoing research, and second, we should pursue new research. With
regard to the former, we must find ways to connect the silos within which much faculty research
is conducted. A central value among SPHCM faculty is the importance of viewing the
determinants of health broadly from an ecological perspective. However, if we wish our
decision makers to take this view, we need to expand our own thinking in this direction by cross-
pollinating our work with the work of our colleagues. With regard to the latter, we believe we
need to complement the individual efforts of faculty grant-writing with a somewhat more
focused research agenda established through a strategic process that anticipates as well as
responds to areas of policy concern.
The choice of focus is important both externally
and internally. It needs to be seen from the outside as SCHOOLS OF PUBLIC HEALTH
sufficiently specific to be clear and cogent (and thus SHOULD EMPHASIZE THE
marketable). At the same time, however, it needs to be IMPORTANCE AND CENTRALITY
sufficiently broad to encompass much of the diversity OF THE ECOLOGICAL
of faculty policy research interests as well as the APPROACH. IOM, p. 111
changing policy landscape. We have, therefore,
recommended a focus that is based in perspectives
(e.g., health ecology) rather than topics (e.g. environmental health), with the understanding that
the topics fall within the perspectives.
We recommend:
The SPHCM should create a Resource Center for Health Policy (Resource
Center) to focus and facilitate policy research and practice. The Resource Center
would be advised by representatives from SPHCM, Law, Public Affairs,
Pharmacy, Medicine and Nursing.
8
The mandate of the Resource Center should be “Translating Science and
Technology into Public Health Policy Research and Practice.” Around this
mandate, the Resource Center should have the following functions:
o Scanning the environment for emerging policy issues, funding
opportunities, and research partnerships;
o Connecting and integrating, as appropriate, ongoing health policy relevant
research across the UW campus(es);
o Assisting faculty who wish to create a health policy frame for faculty-
initiated projects in any topic area;
o Initiating research projects that fit within its scope, as defined by the
Resource Center agenda (developed in conjunction with the Advisory
body);
o Developing private sector collaborations, both as sources of funding and
as partners in projects funded by third parties;
o Translating into accessible language and disseminating the results of UW
research and analysis to public and private decision makers;
o Maintaining and strengthening, through collaboration with other SPHCM
activities (e.g., the Northwest Center for Public Health Practice, the
Center for Public Health Nutrition), a long term relationship with state
and regional policy makers;
o Addressing specific state health policy issues upon request as resources
permit; and
o Supporting teaching programs relating to health policy.
Resource Center-initiated work should be consistent with four theme areas:
o The multiple determinants of health [the ecological health model – e.g.,
the Center for Public Health Nutrition (Drewnowski, PI), the Health
Promotion Research Center (LoGerfo, PI), and the substantial body of
work conducted by Donald Patrick, Deb Bowen, and others]
o The impact of major new technologies on health care (with special
attention given to the biotechnologies) and their impact on health care
delivery systems [the resource allocation and distribution aspects of
biotechnology, including the impact on health and resource disparities] –
e.g., the Center for Excellence in ELSI Research (Burke, PI); the Genetic
Services Policy Project (Watts, PI); multiple projects directed by faculty
within the Institute for Public Health Genetics
o Optimizing the best of medicine in a health care delivery system in
transition – e.g., the Genetic Services Policy Project (Watts, PI); pending
Labcorp project relating to the cost effectiveness of diagnostic tests
(Sullivan and Ramsey, PIs)
o Achieving primary prevention of illnesses and injuries through the
identification and control of hazards to public safety and health [the
hazards component of the ecological health model] – e.g., the Air
Pollution and Cardiovascular Disease Project (Joel Kauffman, PI)
The Health Policy Analysis Program‟s 30-year legacy of state-focused policy
analysis and dissemination should be continued in the work of the Resource
Center, but the separate identity of HPAP, which is associated with a narrower
range of activities and topics, should not be maintained.
9
The specific agenda for Resource Center-initiated research would be developed in
conjunction with the advisory body (see below).
The SPHCM faculty and their colleagues across the UW campus(es) produce world class
research funded by a variety of project-specific grants and contracts. The results of all of these
projects, at some level or another, could
THE COMMITTEE RECOMMENDS THAT contribute to sound decision making by public
SCHOOLS OF PUBLIC HEALTH and/or private decision makers, a fact that is
ENHANCE DISSEMINATION OF not lost on some funders of policy research.
SCIENTIFIC FINDINGS AND Recent federal RFAs (e.g., the Center for
KNOWLEDGE TO BROAD AUDIENCES, Excellence in Health Promotion Economics
INCLUDING ENCOURAGING THE (CDC) and the Genetic Services Policy Project
TRANSLATION OF THESE FINDINGS (HRSA)) explicitly required significant
INTO POLICY RECOMMENDATIONS
dissemination activities with explicit funding
AND IMPLEMENTATION… IOM, p. 5
for them. Some observers see this as a trend
that will continue if not expand. The SPHCM
has an opportunity (and a responsibility) to disseminate the research findings of its faculty to
decision makers at a time and in a format in which it is useful and accessible.
We recommend:
The Resource Center should engage in a core set of activities around
dissemination of research to decision makers. There should be a designated
director of these activities within the Resource Center and a support staff to
assure their quality, relevance and coordination.
Core dissemination activities should include continued involvement in the
Washington Health Legislative Conference (perhaps in partnership with other
organizations)
The Resource Center should continue involvement in forums such as Safe Table,
and in monitoring reports such as the Pulse Report.
The core should also include maintenance (and enhancement) of an easily
accessible web site through which individuals could access periodic issue briefs
such as those prepared for the Safe Table forums, as well as faculty research
reports and publications. Additional issue briefs and white papers related to
ongoing or completed faculty research should be encouraged, funded by the
specific project grant or contract.
The Resource Center should sponsor an annual policy research conference open
to both researchers and policy makers from around the region that would
highlight specific research projects, their integration, and their relevance to
public policy. A central intent of the conference would be to create a dialogue
between researchers and policy makers.
The Resource Center should consider other activities to further its mission,
including developing and sponsoring conferences and seminar programs, and
initiating a visiting scholars program.
10
There are a number of structural, financing, and
governance issues surrounding the Resource Center that
need to be addressed. While the details of these issues go THE MOST STRIKING CHANGE IN
PUBLIC HEALTH RESEARCH IN
beyond the charge of this Committee, we discussed the
THE COMING DECADES IS THE
overarching values relevant to structure, financing, and TRANSITION FROM RESEARCH
governance. In particular: DOMINATED BY SINGLE
DISCIPLINES, OR A SMALL
A key function of the Resource Center is NUMBER, TO
business development and resource TRANSDISCIPLINARY RESEARCH
generation, particularly with regard to the IOM, p.117
targeted research component. We
recommend that there be significant,
stable funding for these activities that is complemented (as opposed to replaced)
by specific project funds. At a minimum, funds should be provided for support
of the Resource Center director, leadership of the business development and
dissemination functions, as well as adequate staff support and marketing
activities (see below).
We recommend that support for the development of the Resource Center be
pursued with the Deans of complementary Schools (e.g., Law, Nursing,
Pharmacy, Medicine, Evans), perhaps through a request to the Vice Provost for
Research. This request would be formatted as a 5-year strategic plan for
development of the Resource Center.
Because of the multi-school involvement in the Resource Center, a clear
governance structure is essential. While we provide some thoughts in this area in
Section 3, we recommend that more detailed work on issues of appropriate
governance be undertaken by another body. The Department of Health Services
is willing to provide an administrative home to the Resource Center.
The Resource Center‟s activities should be integrated significantly in the
SPHCM‟s development activities.
11
Teaching and Training
THE COMMITTEE BELIEVES
THAT IT IS THE
The students who graduate from the SPHCM are RESPONSIBILITY OF SCHOOLS
the future leaders in public health science and practice, OF PUBLIC HEALTH TO
public health and health services research, and health BETTER PREPARE THEIR
services administration. They must all achieve basic GRADUATES TO UNDERSTAND,
competencies in health policy, including an understanding STUDY, AND PARTICIPATE IN
of the policy process and how information and research POLICY RELATED ACTIVITIES.
affect and are affected by policy. Those who wish to get IOM, p.121
more in depth training and/or specialize in health policy
must have the opportunity to do so.
We recommend:
The SPHCM should offer a health policy concentration/major to students at both
the masters and PhD levels. This concentration could be created through the
Health Policy Research track of the MPH in Health Services for masters students
and within the PhD program in the Department of Health Services and the
Department of Environmental and Occupational Health Sciences for doctoral
students. [Note: Policy is already an important component of two of the degree
programs in the Institute for Public Health Genetics.] As the doctoral program in
the Evans School of Public Affairs is implemented, joint opportunities for
students between this program and PhD programs in SPHCM (particularly in
Health Services and Environmental and Occupational Health Sciences) should be
explored. These concentrations should be aggressively marketed to attract
excellent students of health policy. Adequate support would be required to
develop policy practica, supervise policy capstone and thesis projects, and add
new courses that cannot be found elsewhere on campus.
All required 511 courses in the SPHCM should include content on the policy
perspective. All degree programs should evaluate the adequacy of policy
training beyond the 511 requirement.
The availability of the new Health Policy Certificate Program should be
advertised broadly within the SPHCM and elsewhere on campus as appropriate,
with additional funding as required to accommodate the larger volume of
students.
The list of electives accepted for credit toward the Health Policy Certificate
Program should be continually monitored and updated to include relevant course
work from across the UW Seattle campus as well as the UW Bothell and UW
Tacoma campuses. We should encourage the engagement of students from a
wide variety of disciplines and settings to enrich not only the experience of our
students, but also to increase the connection of the faculty in these areas.
The Health Policy Certificate Program should maintain a web site that serves as a
central resource to students interested in health policy, including courses,
interested faculty, informational resources, and job opportunities.
12
The director of the Health Policy Certificate Program should be responsible for
coordinating the SPHCM's teaching activities, including the maintenance of the
web site. Staff resources should be available to assist in this purpose.
Core health policy content should be developed as a distance module for use in
the expanding array of distance offerings in the SPHCM. This content should
address as many of the basic competencies outlined in Appendix I as is feasible.
Health policy content should be added as appropriate to the various professional
training programs in the
SPHCM, including, for THE COMMITTEE RECOMMENDS THAT
example, the programs offered SCHOOLS OF PUBLIC HEALTH FULFILL
by the Northwest Center for THEIR RESPONSIBILITY FOR ASSURING
Public Health Practice, and the ACCESS TO LIFE LONG LEARNING
Best Practices Workshops in OPPORTUNITIES FOR SEVERAL
the MHA program. DISPARATE GROUPS. IOM, p.125
Additional Thoughts on a Resource Center for Public Health Policy
Mission:
The mission of the Resource Center is twofold: first, to improve the quality of health policy
analysis and decision making at the national, regional, and state levels by increasing the quantity
of accessible policy relevant research and information and by increasing the amount of informed
dialogue about important health policy issues; and second, to heighten the profile of the
University of Washington‟s health policy research capabilities and increase the impact of UW
programs on the emerging health policy debate at all levels. This mission will be accomplished
by integrating, facilitating, initiating, and disseminating health policy research around a theme of
translating science and technology into health policy research and practice.
The Resource Center will be developed as a “utility” for use by faculty desiring to engage in
policy-related research and its dissemination. In order to do so, the Resource Center will provide
six core service functions:
1. Scanning and Monitoring: Assess opportunities for policy research, first by scanning the
mid-to-long-term policy horizon to strategically identify policy research questions upstream of
demonstrable need; and second, by systematically monitoring available sources of financing,
such as federal agencies, and providing potentially interested faculty with information about such
opportunities.
The Resource Center‟s Advisory body will review the scanning function on a quarterly basis to
add its input and to make modifications in the process as necessary. The monitoring function is
currently undertaken in a variety of informal ways by different Schools and Departments. Those
activities will, of course, continue. The Resource Center will add value to these efforts by
searching specifically for cross-School and Department opportunities, and by emphasizing non-
government (e.g., foundation) initiatives. The two added activities will be (a). more systematic
coordination of existing monitoring to identify cross-School and Department projects, and (b). a
greater emphasis on non-governmental initiatives and opportunities, such as developing profiles
of health care foundations.
13
2. Policy Research Issue delineation: For such faculty as may request it, assist in
identifying policy research opportunities and issues and enhancing proposals for research
funding with sharper delineation of policy issues and options (such as, for example, collaboration
with a group of faculty in the preparation of the Center for Health Promotion Economics
proposal recently submitted to CDC by the Department of Health Services).
3. Engaging the Private Sector: Enhance research initiatives and increase funding
opportunities through private sector collaboration. This task will be undertaken in two
fundamental ways by securing private sector engagement in advisory and collaborating roles to
increase the relevance of the work (as with the extensive private sector engagement in the recent
successful proposals on genetic services policy submitted to HRSA), and securing private sector
policy research clients (such as in the two projects currently being negotiated with MEDCO
Health Services, and LabCorp, and ongoing projects such as those of the Health Promotion
Research Center).
Because collaboration with private sector clients can raise issues of scientific ethics and
academic freedom, the Advisory body will oversee the development of policies to guide this
work (consistent with University policies), and will be responsible for monitoring project
development and outcomes in this area.
4. Initiating Policy Research Proposals: Initiate new research that fits within the Resource
Center‟s focus as determined in conjunction with the Advisory body. While much of the policy
research work to be undertaken will be secured through responses to RFP‟s and RFA‟s, the
Resource Center will also initiate proposals on topics of significant interest to one or more
faculty, and/or, on topics of crucial policy relevance as identified by the Resource Center‟s
scanning process (and vetted through the Advisory body). Appendix J lists some examples of
health policy research projects in which faculty interest has already been expressed.
5. Dissemination/Translation of Policy Research: Make research results accessible and
available to public and private sector decision makers. This function will increasingly serve as a
differentiator in many competitive policy research areas, especially given the current emphasis
being placed in RFA‟s on “translation” of research findings to affected stakeholder groups. The
Resource Center will develop a strong internal capability in all aspects of dissemination and
translation, including development of publications accessible to a lay audience; support and
ancillary materials in the development of proposals; facilitation of advisory group participation;
meeting planning skills; various electronic systems for interaction such as webcasting; and
conference and seminar development, facilitation and logistics. While an important focus of the
dissemination and translation function will be research conducted with UW faculty involvement,
there will be important policy issues for which UW research is not the only source of research
and information. In these instances, the Resource Center will serve as a translator (as necessary)
and a broker of relevant work conducted by others (as, for example, through a policy research
conference or issue forum). The SPHCM already has significant strengths in this area through
the work of the Health Policy Analysis Program, the Northwest Center for Public Health
Practice, the Center for Nutrition Policy, the Health Promotion Research Center, the Policy
Analysis and Program Evaluation Initiative of the Department of Environmental and
Occupational Health Sciences, and other projects. The Resource Center would coordinate and
collaborate with this ongoing work.
14
The Resource Center‟s dissemination and translation expertise will be a available to all
participating Schools and faculty, but could also be operated as a cost-plus utility.
6. Strategic Marketing and Positioning: Use proven marketing techniques to enhance the
visibility and success of the University‟s health policy research programs. In addition to the
scanning and monitoring functions outlined in (1) above, another successful approach is to
develop workshop and seminar programs to add visibility to the University‟s capabilities. Some
examples of this approach include the policy research conferences sponsored by HPAP in the
past, many of the institutes sponsored by the NWCPHP, the new Best Practices Leadership
programs developed by Denny Pointer, and a panel presentation being developed for the
Grantmakers in Health Annual Meeting in early 2005 that affords us the opportunity to present to
the leadership of most of the health care foundations in the U.S.
Financing and Governance:
Adequate resources and appropriate governance are essential to the success of the Resource
Center. While a full exploration of these important aspects of the Resource Center‟s operation
are beyond the scope of this report, we offer the following thoughts.
Given the multidisciplinary nature of the work, involvement of a number of Schools,
Departments, and Institutes across campus is important to the Resource Center‟s operation. The
SPHCM, given its desire to respond to the IOM‟s directives around health policy, is prepared to
take the lead role in creating the Resource Center, but will seek collaboration and co-sponsorship
across the campus.
Ideally, resources (either real or in-kind or both) would come from all partners in proportion to
the participation of their faculty and the benefits they derive from the Resource Center‟s
activities. Similarly, governance responsibility should be shared by the partners, again in
proportion to their participation. A number of questions in this area need to be answered:
Who appoints the director of the Resource Center?
If the governance is shared among the participating entities through a governing
committee, who determines the committee‟s membership?
In particular, is membership conditioned on resource contribution? Do in-kind
resources “count” on equal terms with financial resources?
Are there different levels of membership (e.g., voting and non-voting) that carry
different conditions?
Who appoints the specific members of the committee?
What are the powers and responsibilities of the committee?
Does the director of the Resource Center report to the committee, and to whom
does the committee report?
Given the importance of collaboration with non-University partners, is there a
governance role for these entities, or should there be a separate advisory (as
opposed to governing) body to include their perspectives?
With regard to resources, there are additional questions:
15
What level of core support is adequate to maintain the central functions of the
Resource Center?
Where should these resources come from?
o A flat tax on participating entities?
o “Sales” of committee membership (offered, perhaps, at different levels of
“price” and participation)?
o A proportion of the indirect costs of the projects that are run through the
Resource Center?
o Inclusion of Resource Center personnel in the direct costs of grant
proposals?
o External development activities?
o Other?
Five-Year Strategic and Implementation Plan
16
Research and Analysis/
05 06 07 08 09
RCHP
Strategic Plan Process;
Completion of Strategic Launch of RCHP
Plan; UW approvals
Secure Core Financial Breakeven National
Secure “outpost”
Implementation Support; three reached; 5 proactive Recognition;
Genomics capability
Milestones proactive proposals; three one of three “best”
from RWJF
proposals secured overall Policy Pro-grams
SPHCM, Law, Public
Participating Schools/ SPHCM, Law, Public Business School
SPHCM, Law Affairs; Pharmacy,
Departments Affairs; Pharmacy added
Medicine, Nursing
Overall Gain in
participating School 2% 3% 5% 7.5% 10%
Revenues; net
RCHP Gross Revenues,
.75M 1.50M 3M 4M 5M
per Year (cumulative)
ROI, per Year 2:1 4:1 6:1 8:1 10:1
Dissemination/detail
Consolidation of Launch of
Establish RCHP Functions, e.g., Conferencing/
capability Surveying/ Meeting planning
Prioritizing RFA‟s functions
Meeting Planning Consolidation of
In-House “Utility” support; e.g., Literature Search and Breakeven on Net Revenues, 20% 30%
services WEBinar Proposal Support Dissemination Costs surplus over costs surplus
capability functions
Executing on Safe
Meeting/conferencing First major RCHP Three sponsored/ Five sponsored
Tables Programs, ETC.
activity Conference Financed Meetings Meetings
annual Leg. Conf.
Teaching/Training
17
In sum, the Committee believes the SPHCM, in keeping with the recommendations of the Institute of
Medicine, has a significant obligation and an important opportunity to focus and enhance its health
policy activities in research, teaching and training, and dissemination. The multidisciplinary
Resource Center for Health Policy proposed in this report provides a necessary focal point for this
work. As a next step in bringing the Resource Center to life, the Committee recommends the
formation of a small working group to address the financing and governance issues raised in this
report.
18
Appendix A
Charge to the Committee
SCHOOL OF PUBLIC HEALTH AND
COMMUNITY MEDICINE
OFFICE OF THE DEAN
BOX 357230
206-543-1144
TO: CINDY WATTS, CHAIR
AARON KATZ
MELISSA AUSTIN
WYLIE BURKE
ALISON CULLEN
JEFF HARRIS
PAT KUSZLER
MIKE SILVERSTEIN
WILL WELTON
JACK THOMPSON
SHARON MORRIS
SEAN SULLIVAN
ADAM DREWNOWSKI
TOM KOEPSELL
DEBBIE WARD
RICK DEYO
BOB CRITTENDEN
BILL DOWLING, EX OFFICIO
RICK CARLSON, CONSULTANT
FROM: PATRICIA W. WAHL, PHD
DEAN
SCHOOL OF PUBLIC HEALTH AND COMMUNITY MEDICINE
DATE: JANUARY 7, 2004
RE: HEATH POLICY CHARGE LETTER
Thank you for your interest in serving on the Advisory Committee for Health Policy in the School of
Public Health and Community Medicine. The purpose of the Advisory Committee is to examine how
to organize the SPHCM‟s resources, in collaboration with other programs and schools across campus,
to strategically respond to the Institute of Medicine‟s call for involvement and leadership in health
19
policy. A key function of the Task Force will be to identify and engage a broad range of
stakeholders: research partners (on campus and from other academic institutions and research
organizations), market partners (trade associations, industry organizations), public partners
(government decision makers), and funders (public and private). The purpose of this
“stakeholdering” is to explore the (many) strengths of the SPHCM and its partners in relation to the
burgeoning needs of the national and regional health policy community and the interests and priorities
of those who would fund our work.
We are on the threshold of profound enrichment of health care and population health through the
waves of discovery triggered, among other things, by rapid advances in medicine and the sequencing
of the human genome. The pace of public policy development to guide the implementation of these
technologies, however, is poorly matched with the pace of their discovery. It is clear that the ability
of scientific research to produce better health outcomes is compromised by the inadequacies, even
perversities, of our health care system‟s existing organization and financing. Beyond the challenges of
genomics, growing consumerism, demographic changes, and workforce trends lie others associated
with the vital need to calibrate the power of these new technologies with the social, ethical, economic
and policy issues that they create. Thoughtful and well informed policy processes that integrate our
knowledge base and our societal values to address these and other thorny health care issues have
never been more important.
Health policy is the “discipline” that systematically studies how science, values, and decision
processes combine to generate public decisions that guide health care financing and delivery. The
centrality of health policy was recognized by the Institute of Medicine in its 1988 report, The Future
of Public Health, and again in its 2003 report, Who will Keep the Public Healthy. In the latter report,
“contributing to policy that advances the health of the public” was listed as one of the six major
responsibilities of schools of public health. The report recommends that “(f)aculty should be
involved in policy development and implementation for relevant issues and play a leadership role in
public policy discussions about the future of the United States health care system.” (page 2) This is
clearly a fortuitous time for schools of public health to become involved in developing rational policy
processes, informing policy decisions, and training policy makers.
The University of Washington School of Public Health and Community Medicine is uniquely
positioned to contribute in this area. The SPHCM houses and partners with some of the best
scientists in the country: geneticists, bioinformaticists, epidemiologists, biostatisticians,
pathobiologists, toxicologists, and others. SPHCM is also home to national leaders in the social
sciences: economics, law, sociology, program evaluation, bioethics, and others; as well as the clinical
sciences: medicine, nursing, and social work. The Health Policy Analysis Program has carried the
banner for applied policy research and policy analysis for 25 years. In the area of education and
training, SPHCM‟s Department of Health Services has a strong policy curriculum, complemented by
health policy coursework in other departments within the Health Sciences, a strong health law
program in the Gates Law School, and a top national school of public policy in the Evans School of
Public Affairs. The relatively new Ph.D. program in the Department of Health Services includes
health policy as a core competency. The Department of Health Services also houses the SPHCM‟s
growing commitment to undergraduate education in public health. Within the next six months, a new
Certificate in Health Policy, based in Health Services but drawing upon campus-wide teaching
resources, will also be available to master‟s students in SPHCM and other schools across the campus.
SPHCM is poised to have a seat at the national health policy table that will debate the issues brought
20
to us by increasing technology, growing needs, and limited resources; but we must think strategically
about how to best to get there.
The exploration of SPHCM‟s best course of action is an iterative and interactive activity. It involves
parallel work within and outside the University. We have long been successful at the usual
mechanisms for obtaining support (responding to RFP‟s) from the usual sources (NIH, AHCQR,
RWJ). But in a climate of spending austerity among our old funding partners, we need to seek new
approaches and new partners to complement them. Given the nature of the issues we might seek to
explore, our new partners might include regional foundations with wider mandates, corporate support
(primarily from corporate foundations), mixes and matches of the above. We might also consider
prudent use of innovative financing models such as industry-based shared-research models, wherein
stakeholders might be persuaded to finance the work.
An important piece of the Advisory Committee‟s task is to consider the extent to which SPHCM‟s
efforts should be guided by specific themes. The need to seek non-traditional funding sources,
specifically from private sector organizations, suggests the importance of positioning: that is,
focusing our initiatives around a set of topics and activities that form a coherent whole that can be
articulated. Some obvious candidates for such a theme are genomics, environmental health,
occupational health, nutrition, chronic disease, and workforce issues.
SPHCM‟s success in mounting a nationally recognized health policy research program will depend
upon our ability to think strategically, to engage the right research and market partners, and to secure
sufficient financial support. The work of the Advisory Committee is central to beginning this
process. Specifically, the Committee is asked to:
1. Conduct an environmental scan to identify both “customers” and competitors for this work.
2. Develop a five-year strategic plan for building greater health policy content throughout the
SPHCM, coupled with a realistic implementation plan, recognizing that over 80% of
SPHCM‟s funding comes from grants and contracts. The strategic plan should address
SPHCM‟s involvement in all four legs of the health policy stool: teaching, research, policy
analysis, and translation and dissemination.
3. Identify key intersections of SPHCM with other units, both on campus and in affiliated
institutions and agencies, that could be expanded to enhance health policy across the
University.
4. Determine education and training opportunities in health policy development and
implementation for both degree-oriented students and others, including relevant professionals
in the community.
5. Determine research and funding opportunities in health policy-related issues relevant to the
health of the public.
6. Explore the advantages of focusing our activities around one or more specific themes.
7. Investigate the relative advantages and disadvantages of alternative structures that might
organize our initiatives; for example, a center, an institute, a resource center, or a permanent
steering committee.
8. Determine the most appropriate role for the Health Policy Analysis Program within and across
each of the four areas of activity (teaching, research, policy analysis, and translation and
dissemination), and HPAP‟s relationship to any new structure that might be created.
I expect that the Advisory Committee‟s work will begin in January, and run through spring quarter.
Thank you for agreeing to be part of this important venture.
21
Appendix B
Roster of Committee Members
Melissa Austin, Ph.D.
Tom Koepsell, MD, MPH
Professor, Epidemiology
Professor, Epidemiology
Director, Institute for Public Health Genetics
School of Public Health
School of Public Health
Wylie Burke, PhD, MD Patricia Kuszler, MD, JD
Professor and Chair, Medical History & Ethics Professor; Associate Dean for Faculty
Adjunct Professor, Medicine, Epidemiology Research and Development
School of Medicine School of Public Health School of Law
Rick Carlson, JD Sharon Morris, BA
Clinical Professor, Health Services Senior Lecturer; Assistant Chair for
School of Public Health Community Outreach Environmental Health
Consultant to the Committee School of Public Health
Bob Crittenden, MD Michael Silverstein, MD, MPH
Associate Professor, School of Medicine Assistant Director for Industrial Safety and
Chief of Family Medicine Service Health Department of Labor and Industries
Harborview Medical Center WISHA Services Division
Rick Deyo, MD, MPH
Sean Sullivan, PhD
Professor, Division of Gen. Internal Medicine
Professor, Pharmacy School of Pharmacy
Co-Director, Robert Wood Johnson CSP
Health Services School of Public Health
School of Medicine
William L. Dowling, PhD, MA, MBA Jack Thompson, MSW
Professor and Chair, Health Services Senior Lecturer, Health Services
School of Public Health Director, Northwest Center for Public
Ex-officio member Health Practice School of Public Health
Adam Drewnowski, PhD, MA Debbie Ward, PhD
Professor,Epidemiology Associate Professor
Director, Nutritional Science Program Psychosocial & Community Health
School of Public Health School of Nursing
Cindy Watts, PhD
Jeff Harris, MD, MPH, MBA
Professor, Health Services
Senior Lecturer, Health Services
Director, Northwest Health Leadership
Associate Director, Health Prevention Research
Institute School of Public Health
Center School of Public Health
Chair of the Committee
Will Welton, DrPH, MHA
Aaron Katz, CPH
Senior Lecturer; MHA Program Director,
Senior Lecturer, Health Services
Health Services
School of Public Health
School of Public Health
22
Committee Staff
Barbara Brooner Kerri Petrin, MPH candidate
Policy Analyst, Environmental Health Research Assistant
School of Public Health Institute forPublic Health Genetics
School of Public Health
Michele Ritala
Communications/Events Manager, Health
Policy Analysis Program
Health Services School of Public Health
----------------------
A member of the Evans School of Public Affairs faculty originally on the committee was
unable to serve for health reasons.
23
Appendix C
Site Visit Reports
Site Visit : Stanford and Berkeley
February 27, 28, 2004
Synopsis: The occasion for the site visit to Stanford was a one day conference at the Law
School, sponsored by the Law and Biosciences program. The topic for this conference was policy
formation around Pre-implantation Genetic Diagnosis (PGD), but there is a wide array of projects
within the program.
Beyond the Law and Biosciences program, there are many disparate policy related activities at
Stanford, but little, if any, effort to connect them. An example is the well known Center for Disease
Prevention Research, run for many years by Jack Farhquahr, M.D.
____________________________________________________________
Site Visit: Johns Hopkins Genetics and Public Policy Center.
March 17, 2004
Synopsis: This Center, in design, is fundamentally different than the others reviewed,
primarily because its Director, Kathy Hudson, PhD, formerly with NHGRI/NIH, secured a $9.9M
grant from the Pew Foundation, leaving the site for the work to be undertaken through the grant to be
largely determined by Dr. Hudson. The Center also had a mandate from PEW to initially, and
perhaps, on a continuing basis, to focus on reproductive genetics. This work is now well underway,
with a primary focus on survey research.
Structurally, the Center reports to the Phoebe R. Berman Bioethics Institute at Hopkins,
and is situated at the same location, which is the Washington DC campus of Johns Hopkins. Dr.
Hudson specifically elected a fairly independent model for the Center, which is governed by a semi-
independent Board of Advisors and located on Hopkins‟ D.C. campus. This degree of independence,
however, was largely determined by the leverage Dr. Hudson had, having first secured substantial
funding.
____________________________________________________________
Site Visit Report: University of Berkeley, School of Public Health
April 1, 2004
Synopsis: An interview with Jaime Robinson, PhD, at the School of Public Health yielded the
following points:
1. The policy focus at Berkeley is largely classical health services research (social science research);
2. The School of Public Health is the hub around which most policy work revolves, but the School is
also substantially financed by hard money, so the choice of research topics is fairly diverse;
3. Policy work drawing on the health sciences is either undertaken jointly with the Institute for Health
Care Policy at UCSF ( through Hal Luft ), or in collaboration with the School of Medicine at UCSF;
4. Research related to genomics is of growing interest, and the Berkeley campus is very active in
overall technology related research.
5. Finally, from a structural perspective, policy work is not centered anywhere, but undertaken on a
project basis as each project is developed.
24
____________________________________________________________
Site Visit Report: Duke University “Genome, Ethics, Law and Policy Program” (GELP).
March 18, 2004
Synopsis: I met with Bob Cook-Deegan, Director of GELP, and with three faculty members
participating in the GELP program, James Boyle, Clark Havighurst, and Arti Rai, all from the Duke
Law School.
GELP is a part of a larger Institute at Duke, The Institute for Genome Sciences and
Policy. The Program is multi –departmental, drawing from the Law School, the Medical School, the
Sanford Public Policy program, and the Fuqua School of Business.
GELP was launched in 2003, and has not yet completed its program development activities.
There will be a relatively large emphasis on Law School involvement, in particular intellectual
property and patent issues. Structurally, GELP is highly integrated into the University. It has
developed a policy to eschew private sector financing.
____________________________________________________________
Site Visit: University of Colorado; Colorado Health Institute
March 13, 2004
This site visit included two organizations: the University of Colorado, the Center for Bioethics
and Humanities, and the Colorado Health Institute.
Synopsis: The University has relatively little health policy activity, as such. The Center does
address policy issues in the bioethics areas, but primarily through conferences and workshops, the
most prominent of which is its Summer Workshop Series on Bioethics, which usually focuses on
genetic issues. Last summer, it was testing, and this summer, 04, the subject is race and genetics.
The more relevant organization from a policy perspective is the Colorado Health Institute
(CHI ) recently formed through the financing efforts of three regional Foundations, Rose, Caring for
Colorado, and The Colorado Trust.
The idea behind CHI was that since all three Foundations are active in the health care
community, and were processing a number of proposals, that CHI could be both arbiter and program
developer for the health field, rendering the funding process both more efficient, as well as providing
the Foundations and the State a more “expert” organization to process proposals, as well as
undertaking independent work on State health policy issues.
____________________________________________________________
Site Visit : Tufts University, School of Nutrition, Science and Policy
April 14, 2004
Synopsis: I had a thorough and highly informative discussion with Irvin Rosenberg, the
Executive Director of the Center, arranged through Adam Drewnowski.
Tufts has established its program as probably the pre-eminent policy research program in
human nutrition. It is organized around two tracks: the science track, and a social policy track. The
School is a sterling example of the effectiveness of marketing, even if not called by that name. Few
in the larger health policy world do not know about, and highly regard, this program.
The School seems very well positioned within the academic community, enjoying as it does a
large number of full and part-time faculty relationships. The School has many and diverse sources of
funding, including a substantial level of private sector work, and has more recently added a
substantial endowment.
Very relevant to the Committee‟s work, the School views its role as to the science of human
nutrition as primarily interpretive and translational to a policy world little versed in the field.
25
____________________________________________________
Site Visit: University of Pennsylvania, Center for Bioethics.
April 15, 2004
Synopsis: This Center, directed by Art Caplan, PhD, is often in the news, partly because Dr.
Caplan has positioned himself with the media, and partly, because U. PA was in the spotlight recently
because of the well-reported Gelsinger case. Dr. Caplan was out of town, but I did meet with Jon
Merz, JD, a colleague of Art‟s, and a lawyer at the Center with substantial savvy and experience with
intellectual property/patent issues, in general, but focused substantially on the genomics area.
The Center undertakes a wide range of research and policy projects, and clearly has
established itself as a credible program. Jon was not particularly versed on the structural issues
relating to the University.
One aspect of the interview that holds some lessons was the recent flap between the Center
(and eventually the University administration) and DeCode Genetics, the Iceland based company.
Apparently because of some interpretation questions about the findings rendered by the Center in a
project financed by Decode, the company challenged some of the findings, and refused to pay
remaining balances owing the University for work performed. The dispute was ultimately resolved,
but not without costs and antagonism.
____________________________________________________________
Site Visit: Rutgers University, Center for Aging, and Health Services.
April 23, 2004
Synopsis: I met with three researchers at this Center. David Mechanic, PhD, is the Center‟s
director, but he was out of town.
The meetings were organized by Joel Cantor, Director of the Center for State Health Care
Policy, well known to Aaron Katz, and the HPAP staff, and was also attended by Louise Russell,
PhD, and Carol Boyer, PhD, associate Director of the parent Center.
The Center (not the state-focused group, referred to by Joel, as essentially a “wholly-owned”
subsidiary of the parent Center), appears to be very well funded, mostly, I would surmise, due to Dr.
Mechanics guidance. The Center for State Health Care Policy, itself, enjoys substantial funding,
much from national sources, though its research work is largely focused on New Jersey, since it is a
public university. The Center takes on only a small amount of private sector work because it has been
so successful in securing funding from established public and foundation sources.
The Center, notwithstanding its more general sounding name, focuses substantially on the
mental health needs of an aging population, and, I believe therefore, that partly its success is due to
strategic positioning, intentional or otherwise.
26
Appendix D
List of Faculty and Key Informant Interviews
Sandra Archibald, Ph.D.
W.H.Knight, Jr., JD
Professor and Dean
Professor and Dean, School of Law
Evans School of Public Affairs
Melissa Austin, Ph.D.
Tom Koepsell, MD, MPH
Professor, Epidemiology
Professor, Epidemiology
Director, Institute for Public Health Genetics
Wylie Burke, PhD, MD Patricia Kuszler, MD, JD
Professor and Chair, Medical History & Ethics Professor; Associate Dean for Faculty Research
Adjunct Professor, Medicine, Epidemiology and Development
School of Medicine School of Law
Andrew Coburn, Ph.D.
Bill Lafferty, MD
Professor and Director, Institute for Health Policy
Associate Professor, Health Services
Muskie School of Public Service
Director,Health Policy Research Track
University of Southern Maine Portland, Maine
Bob Crittenden, MD
Patricia Lichiello, MA
Associate Professor, School of Medicine
Acting Director, Health Policy Analysis Program
Chief of Family Medicine Service
Health Services
Harborview Medical Center
Alison Cullen, ScD Paul Miller, JD, Commissioner
Associate Professor, Evans School of Public Equal Employment Opportunities Commission
Affairs (joined the faculty of the School of Law, Fall 04)
Rick Deyo, MD, MPH Sharon Morris, BA
Professor Senior Lecturer; Assistant Chair for Community
School of Medicine Outreach
Co-Director, Robert Wood Johnson CSP Environmental Health
Nives Dolshak, Ph.D. Mike Silverstein, MD, MPH
Assistant Professor, Policy Studies Assistant Director, Industrial Safety and Health
UW Bothell Dept. of Labor and Industries
William L. Dowling, PhD, MA, MBA Don Sloma, MPH
Professor and Chair, Health Services Washington Health Foundation
Adam Drewnowski, PhD, MA Sean Sullivan, PhD
Professor,Epidemiology Professor, School of Pharmacy
Director, Nutritional Science Program Professor, Health Services
27
JoLynn Edwards, Ph.D. Jack Thompson, MSW
Professor and Director Senior Lecturer, Health Services
Policy Studies Director, Northwest Center for Public Health
UW Bothell Practice
Jeff Harris, MD, MPH, MBA
Greg Vigdor, JD, MHA
Senior Lecturer, Health Services
President
Associate Director
Washington Health Foundation
Health Prevention Research Center
Tom Hazlet, Pharm D., Dr.Ph. Debbie Ward, PhD
Assistant Professor, School of Pharmacy Associate Professor, School of Nursing
Will Welton, Dr. PH, MHA
David Kalman, Ph.D.
Senior Lecturer, Health Services
Professor and Chair, Environmental Health
Director, MHA Program
Aaron Katz, CPH
Senior Lecturer, Health Services
28
Appendix E
Health Policy Analysis Tutorial
Health Policy Analysis Tutorial
Prepared for the
Health Policy Advisory Committee
February 2004
What is Policy Research?
The development of new information
designed to address a public policy
issue.
For example:
“Community Tracking Study,” Center for Studying
Health System Change, funded by RWJF.
"Risk Adjustment for Managed Care Capitation,"
Cindy Watts and Margaret Stanley (Health Care
Authority), funded by RWJF.
29
What is Policy Analysis?
A synthesis of economic, social, scientific, and
political research findings that is designed to
offer a series of options for resolving problems,
including a discussion of pros and cons of these
options.
For example:
“State Planning Grant Project on Access to Insurance,” HPAP,
funded by HRSA.
"Insurance Financing of Integrated Medicine," Willliam
Lafferty et al, funded by National Institutes of Health.
The Policy Analysis Framework
• Identify and define the public policy issue
• Understand the economic market context
• Identify the stakeholders, their values and
interests
• Determine potential options for public policy
action
• Analyze strengths and weaknesses of options
What is Policy Development?
Policy development is a process that uses data,
other information, and community values to
address community problems or build
community capacity; weighs the costs and
benefits of policy options; chooses a desired
option; and recommends programs and services
to carry out that policy.
30
Key Characteristics
of Policy Analysis Projects
• Sponsorship
– Who sponsors the project – decision-making
entity, other stakeholder, external funder?
• Timing
– Is the product targeted to inform a specific,
date-certain decision?
• Funding
– Who funds the project – decision-making
entity, other stakeholder, external funder?
Project Examples
by Key Characteristics
Sponsor Timing Funding
Certificate Specific
Legislature Legislature
of Need decision, not
date-certain
Premera Stakeholder Specific External
Conversion groups decision, funder +
date-certain stakeholders
State Governor’s No specific HRSA
Planning Office decision,
funder
Grant
deadline
How Research and Analysis Influences
Policy
• Shapes thinking about issue (long term)
• Identifies factors that influence issue (short
term to long term)
• Elucidates options for resolving issue
(short term to medium term)
• Can provide specific models (short term)
31
Leverage Points in the Policy
Development Process
Monitoring & Evaluation
Implementation Policy Development
Where can University
have impact?
Policy Dissemination
Methods of Policy Research
and Analysis Dissemination
• Peer reviewed journals
• “Popular” journals
• Media relations/op-eds, press releases
• Briefs, white papers, fact sheets, reports
• Conferences, briefing sessions
• Testimony
32
Policymakers’ Preferences
for Information
• From a credible, trusted source (university?)
• Relevant to and timely for decisions policy makers
are facing
• Prepared in short, concise, user-friendly documents
• Includes inferences and discusses pros and cons,
rather than just presents data
• Focuses on what is known and the implication of
what is known, not what needs further study
• Flows from relationships with policy makers, with
researcher sometimes an informal resource
• Disseminated via seminars, briefings, personal
meetings (Safe Table Forums)
• Available on the Web
33
Appendix F
Health Policy Certificate Program
Health Policy
The Graduate Certificate Program in Health Policy (CHP) is available for
students already enrolled in University of Washington graduate degree
programs. Priority is given to students enrolled in programs within the School of
Public Health. Applications are accepted throughout the year and reviewed
quarterly. Students will qualify for the certificate upon completion of three
required courses, elective courses, and a capstone project.
The three required courses are:
HSERV 552, Health Policy Development (3 credits)
HSERV 587, Health Policy Economics (3 credits)
HSERV 551, Health Law (2 credits)
or
HSMGMT 590 M, Health Administration Law (4 credits)
Required courses must be taken for a grade.
Students choose electives from a list of approved courses, for a total of 15 credits
(8-10 from required courses and 5-7 elective credits).
In addition, during the quarter in which the student finishes the CHP course
work, s/he will write a comprehensive case study of a health policy issue of the
student‟s choice. The case study must include a definition of the issue, a
description of the context of the issue (including relevant political and historical
factors, laws, regulations, and major court cases), the economic markets affected
by the issue, the stakeholders involved in the issue and their priorities/interests,
2-3 options for addressing the issue (including the relevant decision-maker to
implement the option) and the advantages and disadvantages of each option, and
a final recommendation as to the appropriate course of action. The case study is
expected to be 5-10 pages in length, not including the bibliography.
The student will select 2 faculty members to review and comment on the
capstone project, one of which must come from the student‟s home department
or school, and one of which must come from the Department of Health Services.
Students who wish to receive credits for an extensive case study can do so
through the independent study mechanism.
Completion of the Health Policy certificate program will be acknowledged on
the student's official UW transcript. The student must be a matriculated UW
34
graduate student during the quarter the graduate certificate is awarded.
Certificates cannot be awarded retroactively.
Application Instructions
Students may apply to this program at any time during their graduate school
tenure.
(Note: All required courses counting toward the certificate must be taken for
grades. This should be considered if the student decides to take required
courses prior to entering the program).
To complete the application, send the following items to:
Professor Carolyn Watts,
Department of Health Services,
University of Washington,
Box 357660,
Seattle, WA 98195.
1. The completed Graduate Certificate program application form:
Application Form
2. Current UW graduate school transcripts. Available at:
www.washington.edu/students/reg/transcripts.html
For additional information contact Prof. Watts at watts@u.washington.edu
Approved Electives
HSERV 553, Politics of Health Care
HSERV 554, Health Legislation Seminar
HSERV 522, Program Evaluation
HSERV 572, Community Development for Health
HSERV 580, Society, Chronic Illness, and Disability
HSERV 514, U.S. Health and Health Care III: Health Policy Research
HSERV 534, Comparative Health Systems
HSERV 531, Problems in International Health
35
PHG 512/LAW 562, Legal, Ethical, and Social Issues in PH Genetics
PHG 522, Ethical Frameworks for PH Genetics
PHG 523, Genetics and the Law
ENVH 471, Environmental Health Regulation
ENVH 584, Occupational Health and Safety: Policy and Politics
MHE 523, Biomedical Ethics
MHE 535/LAW H503, Medical Ethics and Jurisprudence
NURS 568, Health Politics and Policy
NURS 527, Managing Effective Access and Utilization Within Care
Systems
NURS 584, Critical and Interdisciplinary Approach to Health Policy
PHARM 532, Methods of Pharmaceutical Policy Analysis
ECON 550, Public Finance
ECON 450, Public Finance
POL S 578, Health Politics and Policy
POL S 575, Public Policy Processes
PB AF 501, Legislative Relations
PB AF 506, Ethics and Public Policy
PB AF 513, Public Policy Analysis
PB AF 522, Budgeting
LAW A597, Fundamentals of Health Law
LAW H510, Topics in Law and Medicine
LAW H530, Disability Law
LAW A534, Beginning and End of Life: Rights and Choices
LAW B505, Medical Malpractice
LAW E518, Ethical Issues in Public Health
LAW H580, Advanced Health Law
LAW H570, Biotechnology and the Law
36
Appendix G
Potential Funding Sources
Entity Match Fund Range Due Dates
for policy analysis, research, evaluation, and
RWJ Changes in Health demonstration projects that provide public and
<$100,000 -
Care Financing and Yes. private decision leaders with usable and timely Open
$500,000
Organization information on health care policy and financing
issues
AHRQ Grant Program
Rolling
for Large Conference Yes <$50,000
until 7/06
Support
AHRQ Small Grant
Program for Conference Yes <$50,000 Rolling
Support
March 24th;
…encourage preliminary, exploratory, or
AHRQ Small Research July 24th;
Yes innovative research in new or previously < $100,000
Grant Program November
unexamined areas.
24th
Rolling and
California Healthcare 50,000 –
Yes record of funding projects in other states specific
Foundation 750,000
RFPs
The goal over the next five years is to promote
health among vulnerable individuals and
communities through programming that:
Kellogg Foundation Yes empowers individuals, mobilizes communities, Wide variety Rolling
engages institutions, improves health care quality
and access, and informs public and marketplace
policy.
Pew Advancing Policy current policy priorities include „Genetics & Inquiry to
Yes
Issues Public Policy‟ Invitation
We support independent research on health
TheCommonwealth
Yes and social issues and make grants to improve Varies Rolling
Fund
health care practice and policy.
… the Trust supports a wide variety of
Murdock Foundation Yes Varies Rollins
projects and programs in the region
Arts & Culture, Youth Engagement, Community
Paul G. Allen Charitable
No Development & Social Change, and the Scientific
Foundation
& Technological Innovation Programs
Macarthur Foundation N Policy research interest don‟t match
Quality of care; Disparities in health; End-of-life
Atena Foundation ?
care; Connecticut; Diversity; Community Grants
Bill & Melinda Gates
? Global health issues and community projects
Foundation
Asset building and community focus;
Ford Foundation ? Knowledge; creativity and freedom; Peace and
social justice
John A. Hartford training of doctors, and other health professionals
?
Foundation innovations in delivery of service
37
Appendix H
Academic Policy Centers
Name Center for Health Policy and Research
University Connection University of Massachusetts Medical Center
Director Jay Himmelstein, MD, MPH
Website www.umassmed.edu/healthpolicy
To promote and conduct applied health policy evaluation, research and education
aimed at improving the health and well-being of the people of the
Mission
Commonwealth of Massachusetts, with a focus on persons with disabilities and
those eligible for services from public agencies."
Type Academic
●provide resources for health policy research activities on the UMass campus
●promote collaborative evaluation and policy development efforts between
Major Activity UMass and state agencies ●support innovations and quality initiatives in the
UMass Memorial Health Care Clinical System ●enhance and develop
educational programs at the undergraduate and graduate levels
● long-term care policy ●research design and methods ●state health policy
Emphasis
analysis ●work and health policy
Funding not listed
●Joint UMass/Harvard Ph.D. and postdoctoral program in occupational health
services research ●Joint UMass/Amherst Ph.D. program in Health Policy and
Teaching
Management ●Post-doctoral research trainingGenetics and Public Policy Center
- Johns Hopkins University
Name Genetics and Public Policy Center - Johns Hopkins University
The Center is part of the Phoebe R. Berman Bioethics Institute at Johns Hopkins
University Connection
University.
Director Kathy Hudson, PhD
Website www.dnapolicy.org
The goal of the Center is to create the environment and tools needed by key
decision-makers in both the private and public sectors to carefully consider and
Mission
respond to the challenges and opportunities that arise from scientific advances in
genetics.
Type Academic
●conducts research projects ●publishes a quarterly newsletterReproductive
Major Activity
Genetics
Emphasis Reproductive Genetics
Funding The Pew Charitable Trusts
Teaching None
Name Center for Genome Ethics, Law and Policy
The Center is a core component of Duke University's Institute for Genome
University Connection
Sciences and Policy
Director Robert Cook-Deegan, MD
Website www.law.duke.edu/gelp
Mission Seeks to foster ethically responsible and socially beneficial uses of genome
38
science through research, teaching, and public discussion
Type Academic
Major Activity Genomics
Emphasis Not Listed
●The Duke Endowment ●Duke University Medical Center ●Duke University
Funding Institute for Genome Sciences and Policy ●Fitzpatrick Foundation ●grants to
individual center faculty
Teaching Postdoctoral
Name Center for Bioethics
University Connection University of Pennsylvania
Director Arthur Caplan, PhD
Website www.bioethics.upenn.edu
The Center employs [the language of bioethics] to promote scholarly and public
Mission understanding of the ethical, legal, social, and public policy implications of
advances in the life sciences and medicine.
Type Academic
●conducts empirical, interdiscplinary research ●maintains bioethics resources
Major Activity
on the internet ●publishes a biannual newsetter ●holds a lecture series
Emphasis 'Bioethics
The UPenn School of Medicine provides the budget for operating support.
Additional support comes from Government agencies (including the Department
of Health and Human Services/HRSA, NASA, NIH, and the Office of Naval
Funding
Research); Tuition and foundations (including the Alpha-One Foundation, the
Walter & Elise Haas Foundation, the Hospice Foundation of America, The
Greenwall Foundation, and PETsMART charities)
Master of Bioethics, co-sponsors an undergratuate concentration, is involved in
medical school education, both teaches and advises students, maintains a
Teaching
growing array of continuing and executive education courses, and provides
clinical consultation.
Name Center for State Health Policy
University Connection Rutgers University
Director Joel Cantor, Sc.D.
Website www.cshp.rutgers.edu
The Center employs [the language of bioethics] to promote scholarly and public
Mission understanding of the ethical, legal, social, and public policy implications of
advances in the life sciences and medicine.
Type Academic
●conducts empirical, interdiscplinary research ●maintains bioethics resources
Major Activity
on the internet ●publishes a biannual newsetter ●holds a lecture series
●long-term care ●access to care ●racial and ethnic health disparities ●health
Emphasis care performance measurement ●pharmaceutical ●state health data and
information
Funding Main Funding Sources Robert Wood Johnson Foundation
Teaching None
Name Friedman School of Nutrition Science and Policy
39
University Connection Tufts University
Director Irwin Rosenberg, MD
Website www.nutrition.tufts.edu
To improve the nutritional well-being of people worldwide through: the creation
Mission of new knowledge, the application and dissemination of evidence-based
information and the education and training of future leaders in the field
Type Academic
Major Activity ●Teaching ●Research
Emphasis Nutrition
Funding Faculty seek their own funding for their specific projects
Teaching Masters and doctoral degrees
Name Center for Health Policy Research
University Connection University of California, Los Angeles
Director E. Richard Brown, PhD
Website www.healthpolicy.ucla.edu
'The Center strives to understand and advance public health policies that can
improve access to health care as well as promote good health among diverse
Mission populations in California and the nation. Throughout its research and other
activities, the Center aims to address disparities and gaps in health studies and
access to health care among a variety of population groups.
Type Academic
●research ●public service - the California Health Interview Survey (CHIS), the
Health DATA program, dissemination of Center publications and research
Major Activity
reports, policy briefings, forums, and seminars, speakers and expert advisors,
media outreach ●education
●access to health care and insurance coverage ●health promotion and disease
Emphasis prevention ●management of chronic conditions ●public programs and the
finance systems of health care
Department of Managed Healthcare (DMHC) First 5 California (California
Children and Families Commission) Henry J. Kaiser Family Foundation Indian
Health Service (IHS) Medi-Cal Policy Institute National Cancer Institute (NCI)
Funding
National Immigration Law Center (NILC) Robert Wood Johnson Foundation UC
Funding: California Program on Access to Care (CPAC) Institute for Labor and
Employment (ILE) Institute of American Cultures (IAC)
Teaching None
Name Public Health and Health Policy Institute
University Connection University of Wisconsin
Director Patrick Remington
Website www.pophealth.wisc.edu/wphi
To become a primary resource for stimulating, creating, and communicating
Mission
useful public health and health policy research and analysis
Type Academic
●development of an internet database for health information ●outreach activity
Major Activity including: Bi-Annual Conferences, production of Health Policy Forums, annual
Wisconsin County Health Rankings
●socioeconomic conditions and demography ●health status ●health services
Emphasis
use ●health care resources
Funding Robert Wood Johnson Foundation ●State of Wisconsin Department of Public
40
Health ●National Institute of Health ●Centers for Disease Control and
Prevention
Teaching None
Name Center for Health Services Research
University Connection University of Tennessee
Director David M. Mirvis, MD
Website www.utmem.edu/center
To coordinate, promote and support health services and health policy research
and education among the faculty and students of the University of Tennessee,
Mission
Memphis, and to apply the talents of the faculty as a resource to policy makers
and planners for enhancing the health of the citizens of Tennessee.
Type Academic
●provides consultation to members of the state legislature and state departments,
as well as health-related organizations in Tennessee ●co-sponsoring of monthly
Major Activity conferences on health-related topics ●publishing Health Care Notes, a quarterly
newsletter ●publishing research briefs ●coordinates a Tennessee
Interdisciplinary Health Policy Fellowship
Emphasis Health services
Funding Not listed
The Center coordinates a Tennessee Interdisciplinary Health Policy Fellowship
for senior law, medical and pharmacy students that rotates fellows through
Teaching
various agencies of state government that are active in health policy and
regulation.Kansas Health Institute
Name Oregon Health Policy Institute
University Connection Oregon Health Science University
Director Not listed
Website www.ohsu.edu/about/leadership.shtml
To develop, implement and evaluate health policy issues that affect Oregon and
Mission
its residents
Type Academic
●health services research ●health policy analysis ●interrelationships between
health policy and other policy issues ●database development ●methods
Major Activity
development ●thesis and dissertation research, professional development and
education ●advice to public agencies and officials
The OHPI includes a collaborative core and four centers: ●Center for Health and
Disability Policy ●Center for Substance Abuse Research and Policy ●Center
Emphasis
for Policy and Research in Emergency Medicine ●Center for Environmental
Health Policy
Funding Not Listed
Teaching None
Name California Policy Research Center
University Connection University of California, Berkeley
Director Andrés Jiménez
41
Website www.ucop.edu/cprc
The Center seeks to improve the health of individuals, families, and populations
Mission by understanding the problems, issues and alternatives in the design and delivery
of health care services.
Type Academic
CPRC informs California decision-makers by sponsoring research and
evaluations of major state programs and policies, drawing from the expertise of
the entire UC system. The Center also oversees legislatively mandated projects
and task forces involving the participation of key stakeholders in such policy
Major Activity areas as education, energy, fiscal policy, land use, natural resources, public
health, social services, and transportation. Research findings and policy
recommendations are made available through publications and special briefings,
as well as activities co-sponsored with University-based programs and state
government entities.
Emphasis
Funding Not listed
Teaching None
Name Cecil G. Sheps Center
University Connection University of North Carolina at Chapel Hill
Director Timothy S. Carey, MD MPH
Website www.shepscenter.unc.edu/index.html
'The Schneider Institute for Health Policy‟s mission is to study emerging issues
Mission related to social policy and to develop society‟s policy alternatives for federal
and state governments.
Type Academic
An interdisciplinary program of research, consultation, technical assistance and
training that focuses on timely and policy-relevant questions concerning the
Major Activity accessibility, adequacy, organization, cost and effectiveness of health care
services and the dissemination of this information to policy makers and the
general public.
Emphasis
Funding State and Federal
Teaching None
Center for Health Policy (CHP)
Name
Center for Primary Care and Outcomes Research (PCIR)
University Connection Stanford University
Director, CHP/PCOR: Alan M. Garber
Director
Executive Director, CHP/PCOR: Kathryn M. McDonald
Website http://chppcor.stanford.edu
CHP and PCOR are dedicated to education and rigorous investigation to
Mission
guide health policy and clinical practices.
Type Academic
Innovative research on critical issues of health care and health policy--
Major Activity
dedicated to providing reliable information for health policy and health
42
care delivery to public and private sector decision-makers.
Emphasis
Funding Donations together with national and international foundations
Teaching Yes
Name Health Policy Institute of Ohio
University Connection None
Director William Hayes
Website www.healthpolicyohio.org
The Health Policy Institute of Ohio is an independent, nonpartisan,
statewide center that informs Ohio health policy by forecasting health
Mission
trends, analyzing key health issues, and communicating current research
to policymakers, state agencies and other decision-makers.
Type Independent
Major Activity Research, Analysis and Communication
Emphasis
The Anthem Foundation of Ohio (based in Cincinnati) The Cleveland
Foundation The George Gund Foundation (based in Cleveland) The
Health Foundation of Greater Cincinnati The Mt. Sinai Health Care
Funding
Foundation (based in Cleveland) Saint Luke‟s Foundation of
Cleveland Sisters of Charity Foundation of Canton with the Sisters of
Charity Foundation of Cleveland
Teaching None
Name Texas Institute for Health Policy Research
University Connection None
Director Camille D. Miller (President/CEO)
Website
To provide leadership to improve the health of Texans through education,
Mission
research and health policy development.
Type Independent
Major Activity Disaster response; education; information; presentations; workforce
A statewide non-partisan organization serving as a catalyst for the improvement
Emphasis in the health of all Texans through education in health policy options and
grassroots community-based health solutions.
Funding State funded
Teaching None
Name Institute for Health Policy - University of Southern Maine
Part of the Edmund S. Muskie School of Public Service at the University of
University Connection
Southern Maine.
Director Andrew S. Coburn, PhD
Website muskie.usm.maine.edu/research/research_institutes_ihp.jsp
Mission Through a diverse range of research projects, public service activities, and
43
partnerships, the Institute for Health Policy seeks to increase access to health
care, enhance the quality of care, and eliminate disparities in the availability and
delivery of services.
Type Academic
Major Activity
●children's health and welfare ●health care access & finance ●mental health
Emphasis ●rural health ●chronic illness, disability & aging ●health care quality
management & improvement ●public health
Funding for the Institute come from the Muskie School of Public Service.
Funding Funding within each of the areas of emphasis is accomplished by grants awarded
to individual faculty.
Teaching Yes
Name Center for Rural Health - University of North Dakota
Part of the School of Medicine & Health Sciences at the University of North
University Connection
Dakota.
Director Mary Wakefield, PhD, RN
Website www.medicine.nodak.edu/crh
To serve the people of the state, region and nation. As a resource, we identify
and research rural health issues, analyze health policy, strengthen local
Mission
capabilities, develop community-based alternatives, and advocate for rural
concerns.
Type Academic
Four core areas: ●education and information dissemination ●program
Major Activity development and community assistance ●research - health policy, health
systems, and health personnel ●policy analysis
The Center is the federally designated State Office of Rural Health for the state.
It connects the School of Medicine and Health Sciences and the university to
Emphasis
rural communities and their health institutions to facilitate developing and
maintaining rural health delivery systems.
Funding State funded
Teaching None
Name Center for Health Services and Policy Research
University Connection University of South Carolina
Director John Woods, PhD
Website www.sph.sc.edu/CHSPRmain.asp
To coordinate and conduct research designed to improve the effectiveness,
efficiency, appropriateness and accessability of health care services and to
Mission
inform public policy in a manner that has a positive impact on the health-related
quality of life of South Carolinians
Type Academic
A focal point for coordinating and strengthening research that is relevant
Major Activity
to health services delivery and health policy
We strive to be a science-based, research organization, serving as a link
Emphasis
between academia and the community we serve
44
the four founding organizations: The Palmetto Health Alliance (Palmetto
Richland Memorial Hospital and Palmetto Baptist Medical Center), and
Funding
the University of South Carolina Institute of Public Affairs, School of
Medicine, and School of Public Health
Teaching Not listed
Name Schneider Institute for Health Policy
University Connection The Heller School for Social Policy and Management Brandeis University
Director Not listed
Website www.sihp.brandeis.edu
The Schneider Institute for Health Policy‟s mission is to study emerging issues
Mission related to social policy and to develop society‟s policy alternatives for federal
and state governments.
Type Academic
Major Activity Research
The focus of the Schneider Institute for Health Policy is on the needs of our most
Emphasis
vulnerable populations
Private, RWJ, Kaiser, Kellogg, Blue Cross Blue Shield, NIH, NIDA, NIAAA,
Funding
NIMH, NCI,NICHD AHRQ
Teaching Graduate Level
Name Kansas Health Institute
University Connection None
Director Robert F. St. Peter, MD (President and CEO)
Website www.khi.org
To conduct research and policy analysis on issues that affect the health of
Mission Kansans and to communicate that information so that informed decisions can be
made which optimize our health.
Type Independent
●policy analysis ●evaluation and monitoring ●data development and analysis
Major Activity
●research capacity development ●communication of important findings
Research agenda is determined by certain priorities: ●relevance of projects to
Kansas and Kansans ●inclusion of population-based approaches and a broad
definition of health ●potential for collaboration with other research partners in
Emphasis
the state ●generation of non-partisan, high-quality and timely information
Activities fall into three categories: ●policy analysis and communication
●evaluation and monitoring ●data development and analysis
Funding Almost exclusively funded through the Kansas Health Foundation (KHF)
Teaching None
45
Appendix I
MPH Policy Competencies
PROPOSED MPH1 POLICY COMPETENCIES
4/26/04
USING „MENTAL MODELS,‟ STAKEHOLDER ANALYSIS, AND PUBLIC HEALTH SKILLS TO
SUPPORT POLICY DEVELOPMENT AND EVALUATION PROCESSES
1) Develop and explain one or more systemic model(s) of the policy process, incorporating and integrating
relevant concepts, theory, and empirical evidence. 2
2) Identify relevant stakeholders, explaining their interests, significance, and roles within policy
development and evaluation processes.
3) Explain the roles discipline-oriented public health professionals 3 play in:
a) Informing the policy development process,
b) Managing policy processes, and
c) Analyzing and evaluating public policy effects and outcomes.
ANALYZING POLICY PROBLEMS AND DEVELOPING AND EVALUATING SOLUTION
OPTIONS
1) Collect, summarize, and interpret information relevant to a policy issue.
2) Identify, clarify, and articulate policy problems/issues, policy goals and relevant policy (solution)
options.
3) Analyze policy issues and options effectively within the context of the relevant conceptual framework.
4) Identify and evaluate the expected outcomes and feasibility of policy options.
5) Select and apply current techniques in political and economic decision analysis and decision
management, leading to policy decisions.
6) Identify, interpret, and implement public health laws, regulations, and policies related to specific
policies and programs.
INFORMING, INFLUENCING, AND MANAGING POLICY PROCESSES
1) Define policy issues and goals using evidence from relevant literature, while applying evidence within
relevant social and community context, and within the context of stakeholder interests
2) Provide effective analytic and evaluative support for policy development and policy management
processes.
3) Provide effective advocacy support for policy development processes.
4) Provide effective communication support for policy development processes.
5) Manage policy groups and teams effectively, to achieve policy objectives.
DEVELOPING, MANAGING AND EVALUATING POLICY PROGRAMS
1
Also apply to MHA curriculum
2
Models should articulate social welfare goals and philosophies, and should include and integrate stakeholders and their
interests and relationships, process steps, political and economic decision and feasibility criteria, and decision and
evaluative processes
3
i.e., statisticians, epidemiologists, environmental scientists and environmental health professionals, economists, program
specialists, clinicians, managers, etc.
46
1) Develop policy implementation plans (including goals, outcome and process objectives, and
implementation steps) for translating approved policy options into effective programmatic structures.
2) Monitor and evaluate programs for efficacy, cost-effectiveness, and quality.
47
Appendix J
Potential Health Policy Research Projects
Projects under Development
(* indicates proposal submitted)
1. Center for Health Promotion Economics (Doug Conrad and Sean Sullivan, co-PIs)*
2. Cost Effectiveness Assessment of Pharmocogenomics (Karen Edwards, Wylie Burke, Ken
Thummel, Sean Sullivan, Rick Carlson, in collaboration with MedCo).*
3. Center for Health Law and Policy (Pat Kuszler, Kate Batuello, Cindy Watts, Rick Carlson and
others)
4. The Intersection of Genomics and the ADA (Paul Miller, Pat Kuszler, and others)
5. The Political Economy of the Pharmaceutical Industry: Case Studies (Tom Hazlet, Lou
Rossiter, Cindy Watts)
6. Intellectual Property Issues in Genetics (Pat Kuszler, Rick Carlson)
7. Consumer Directed Health Care: Early Evidence and Implications (Cindy Watts, Rick
Carlson)
8. Genetics for the Judiciary (Pat Kuszler, Kate Battuello, Paul Miller, and Rick Carlson)
Project Areas in which Faculty Interest has been Indicated
1. Occupational health psychology – in conjunction with Portland State University Center
2. Effectiveness of OSHA inspections
3. Case studies of the policy formation process
4. Public health impact of class action lawsuits
5. Public policy around obesity
6. Public policy implications of gene data banks
48
