The importance of public participation and policy development

Many states are struggling to develop budgets and are under severe pressures from seemingly endless mandates from many different sources. Some mandates come from federal laws and others come from contractual obligations and still others come from the constituents themselves. Locally, the end result of this is seen in a NY state budget process that has gone from the original inanity of 'three men in a room' backroom dealing to 'one man making dictatorial emergency extensions.' At this point the populace has been so effectively removed from the budgetary process that I am not even sure they realize yet that lobbying in all of its forms (direct and proxy) is functionally dead. I find it amusing that at least the New York 'three men in a room' process could be lobbied - who would have thought that system could be degraded into something worse??

Inappropriate and ineffective decisions are more likely to be made when the populace is removed from the process of participation. The strength of participatory and representative democratic action is that it allows information and opinion to be fed into the decision making process. I understand that there are potentials for abuse and misuse in this system - and it is important to address those problems - but we don't strengthen our policy development by removing public input and leaving important decisions buried deep within emergency budget extension bills.

I don't mean for this to become a political rant - I want people to understand how this has a direct impact on people's lives. I am thinking about early childhood education in particular this morning and how this applies.

California's budget woes are perhaps more widely publicized than New York's budget woes, but I believe that is because California has not been as successful as NY in developing a workaround to political log-jamming and legislative paralysis. I recall reading a recent California proposal that would increase the entrance age for kindergarten to five years of age. The appeal of this is that it effectively saves the state millions of dollars by delaying entrance into the system - and although it is a short term solution it is an appealing money saving trick because it is easier to cost shift onto the general populace than it is to confront the state pension system or teacher unions, for example.

The justification used for these policy decisions often comes out of think-tanks. Sometimes think-tank work is really sound and helpful; other times it is judgmental and politicized and of dubious quality. The justification cited for the California proposal is a Rand study completed a few years ago that states that delaying kindergarten results in higher math and reading scores. What the study doesn't explain as well is things like:
  • Standard error of measurement on tests, particularly for that age group
  • The tests used are often developmental, meaning that it is expected that a five year old will likely have better 'readiness' and subsequent academic progress than a four year old.
  • These tests tend to have poor predictive validity for children who have difficulties
  • School readiness factors are complex and interact with a multitude of influences that are not fully considered or discussed in this study.
In sum, poorly applied science can lead to bad policy - but people's eyes glaze over if you try to engage them in conversations about standard error of measurement and predictive validity. When there is money to be saved it is difficult for a politician to want to hear a debate about these technical details.

To make matters worse, there is the natural lazy tendency that fosters the thought that 'if State X is doing it then they must have really looked at it and studied the issue so it might be a good idea for State Y.' There is no more insidious spread of poor decisions than that caused by lazy politicians who are simply following the herd. This brings me full circle to the original point - we are shut out of decision making and there is limited opportunity to provide input.

So when I see information from think-tanks being 'passed around' and I see the flawed decision making process flow from California toward New York, and as I see limited opportunity to counter incorrect information I just get a little nervous. Some days it feels like we are struggling to climb and reach for an objective and there are a multitude of forces (some inadvertent and others purposeful) that are greasing the mountainside.

We have a lot to fix with our process. I encourage occupational therapists and other professionals to become more educated and more engaged so that better information can be considered and better decisions can be made. It is not acceptable to just let decisions be made without public input and democratic participation. We all need to do more to make sure our voices are heard and that there is appropriate conversations about forming policy.

Background reading:

Kindergarten readiness bill passes State Senate. Retrieved June 28, 2010 from

Datar, A. (2003). The Impact of Changes in Kindergarten Entrance Age Policies on Children’s Academic Achievement and the Child Care Needs of Families. Retrieved June 28, 2010 from


Speaking of early childhood, I am concerned about early intervention changes that states are making due to budget cuts. To have co-pays in NY state is just ridiculous. Many families who receive early intervention services are of low socioeconomic status. I realize that there will be accommodations made based on financial abilities. Although, low middle class will be expected to pay a co-payment for EI services.

I just finished reading about EI changes in other states in this weeks issue of Advance for OT. Now turf wars amongst therapists are starting due to financial hardships of the states.

I never understand why states cut money from early childhood and EI programs. Research continues to prove over and over again that the earlier problems are addressed the more successful the outcome for the child. Let's put the money where we will get the most bang for the buck. Can you imagine if services continue to be cut, the outcome several years from now as these young children age? If you think special education numbers are high now, hold on folks!
PS - Several years ago NY state thought about going to a starting age of 5 years old for kindergarten.
This is an incredibly pertinnent issue here in the UK at the moment as well.

Our new government has announced its radical policy overhaul for the NHS and there is a lot of concern about the lack of consultation, whether with public or other bodies.

We could be in for a rocky ride.

If anyone is interested, the policy paper can be read here...

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