SPG synthesis report - State Coverage Initiatives

Analysis and Selection of Policy Recommendations: Public Input
Once states designated a lead agency and developed a governance structure for moving
forward, they involved key stakeholder groups in a deliberative process to consider
policy options. States sought input and support from key public and private sector
leaders, including representatives from state departments of health and insurance,
hospitals, advocacy groups, unions, and academic institutions. This public input process
varied from state to state both in terms of from whom the state sought input to developing
policy recommendations, and how and when their input was solicited. In some states this
process was informal and involved myriad ad hoc meetings and educational
presentations. In other states, the public input process was quite formal and entailed
statewide conferences with a carefully orchestrated approach to seeking public input.
By involving a broad array of public and private stakeholders, and communicating their
progress on a regular basis, states effectively used their SPG funds to build a community
of stakeholders with a vested interest in increasing health coverage. States included many
of these stakeholders directly in the SPG project planning through their advisory group
memberships. Other stakeholders were engaged in project planning via focus groups, key
informant interviews, special briefings, and community forums.
Many states took steps to ensure the transparency of the deliberative process by which
they developed policy recommendations. States communicated their activities and
deliberations to the public by holding public advisory group meetings and, in some cases,
by conducting meetings in different regions of the states. Many states also posted project
updates on a designated Web site.
Examples of the different ways that states sought public input include the following.
• California hosted a series of four symposia across the state in early 2002. The state
used these forums as their primary method for obtaining input on reform options
under consideration by the HCOP. The California Research Bureau, a division of the
California State Library, organized the symposia including a mailing of brochures to
900 potential participants. Attendance ranged from about 75 individuals at the Fresno
symposia to 250 at the Oakland site. In all, 600 people attended these events, which
included presentations by the authors of nine reform options. The symposia afforded
opportunities for comments from local stakeholders, and extensive question and
answer sessions which generated nearly 1,000 written question and comment forms.
• In contrast to California’s highly structured approach, Tennessee offers an example
of a fairly informal public input process that was typical of many SPG grantees.
Tennessee’s outreach activities centered on educational meetings with groups that had
expressed an interest in learning more about the project. In addition to these meetings,
project staff had frequent and ongoing informal contacts with a wide array of
providers, insurers, and legislators. The state also established a Web site for the
project that offered information related to the uninsured.
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