growing on the roots of ada's public policy
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Growing on the Roots of ADA’s Public Policytbt
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he American Dietetic Association’s(ADA’s) state affiliates hold a spe-cial place in the development of
ood, nutrition, and health advocacy.rganized, trained ADA advocacy firstegan at the state level. The states pro-ided the essential framework for theevelopment of nutrition policy and de-ivery of messages.
Just as in the past, ADA’s affiliatesre essential to the Association’s suc-esses in improving nutrition. Theirole is complemented by a more robustolicy analysis program, member-di-ected strategy, ongoing professionalobbyists and advisors, and ADA’s re-ewed commitment to train and sup-ort all members to represent them-elves in venues where decisions getade affecting food, nutrition, andealth. This is consistent with ADA’sommitment to improve the nation’sealth and to advance the profession ofietetics through research, education,nd advocacy.
DVOCACY IN THE EARLY YEARSrom its inception in 1917, ADA fo-used on the public good. Foundersena F. Cooper and Lulu C. Gravesrought a group of women togetherith the explicit purpose of helping
he government conserve food and im-rove public health and nutrition dur-ng World War I. From the outset, therganization had a policy focus, al-hough the details are sketchy in thearly years.ADA was barely 6 years old when
ts Board of Directors appointed therst legislative committee. It was923, and ADA had 711 members.he little information available from
This article was written byJuliana Smith, MEd, director ofState Government Relations andM. Stephanie Patrick, vicepresident of Policy Initiatives andAdvocacy in ADA’s Washington,DC office.
fdoi: 10.1016/j.jada.2008.10.020
988 Journal of the AMERICAN DIETETIC ASSOCIATI
hat time suggests that ADA mem-ers were well connected and couldalk to national leaders about issues.
In 1928, ADA got an appointmentith President Calvin Coolidge at thehite House. The content of that meet-
ng has been forgotten, but the photo-raph taken on that day (Figure) showsundreds of women decked out in hatsnd coats, surrounding the legendarilyaconic president—and even he seemsubilant at ADA’s coming to call.
During the Depression, World WarI, and the 1950s, ADA stayed true tots original commitment to food, nutri-ion, and health issues, and advancedhe profession by supporting the dieti-ian’s role in public food and health pro-rams. For example, when the firstood and agriculture programs werestablished in the midst of the De-ression to stabilize farm prices andncomes, government purchases ofurpluses were followed by their do-ation into food programs for schoolhildren and those in need (1). ADAembers’ skill sets were needed.When American troops were mobi-
ized and sent into the battles oforld War II and the Korean War,hat federal researchers had learnedbout nutrition and food safety waspplied so that American soldiersould at least have adequate and safeeals in defense of their country. The
assage of the Public Health Servicect in 1944 underscored the progress,reating the authority to commissionietitians as Public Health Service of-cers on July 1, 1944 (2).Years of war were lean and food
upplies were critical issues to the na-ion and the world at large. Here, theercentage of those engaged in farm-ng dropped from 17% of the work-orce in 1940 to only 6% by 1960, butfter the war American farming wasroductive (3).In the years of peace that eventu-
lly followed, the United States builtations—and foreign relations—bysing surplus foods grown here to
eed hungry people overseas.ON © 2008
960S–1980S: ROOTS OF THE CURRENTROGRAMn nearly every sense of Americanulture and politics, the 1960s were aatershed period. The War on Pov-
rty commenced. Food stamps werereated. Medicare was approved toive America’s older adults access toealth care. Democrat and Republi-an presidential campaigns wereaunched and conducted on the needo address poverty and hunger and tolleviate economic and social dispari-ies.
In 1968—3 years after Medicaread been silent on nutrition andealth, but when food was a nationaloncern—ADA formalized its publicolicy program. The Advisory Com-ittee on Legislation and Public Pol-
cy is the precursor of today’s advo-acy programs. It began its work byeveloping guidelines and proceduresor ADA to engage in legislative andublic policy work.In 1971, ADA established its grass-
oots capabilities in order to deliver itsiew on national and state food, nutri-ion, and health policies. It launchedraining at six regional workshops, giv-ng members basic advocacy and publicolicy tips. The workshops focused onhe overall value of strong state advo-acy initiatives and the importance ofisibility with public policy for theembership.Tactically, ADA began to focus more
n the states for their connections toolicy makers. Legislative Network Co-rdinators (LNCs) were appointed inach state. Their role was to improve
The 2009 Public Policy Workshopprovides an opportunity for all mem-bers to learn about food, nutrition, andhealth policies; understand ADA’s role;and prepare to join the ADA grassrootsnetwork. The program begins Sunday,February 8 and concludes on Tuesday,February 10. For more information andto register go to http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/10882_ENU_HTML.htm.
by the American Dietetic Association
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PUBLIC POLICY NEWS
inkages between ADA members andey lawmakers in Washington, DC andn state capitals. The appointments ofNCs spawned interest and enthusi-sm for public policy initiatives. Licen-ure began to take center stage forDA affiliates. Other food, nutrition,nd health issues were evaluated andramed to reflect ADA’s views through
coordinated network of activists.DA members were informed, orga-ized, and passionate, as the next de-ade would demonstrate.
In 1975, Alabama became the firsttate to enact a regulation law for die-etics, and other affiliates wanted whatlabama dietitians had achieved. Toupport licensure initiatives aroundhe country, ADA provided staff to sup-ort member advocacy. Within the fol-owing 10 years, 34 states had achievedome form of legal recognition (licens-ng, certification, or registration laws).
Today, there are 46 states that havenacted licensure laws in the form oficensure (either title protection only oritle with a scope of practice), certifica-ion, or registration laws. And licen-ure work continues today in the statesithout recognition and to upgrade
tatutes where there already are laws.ADA also monitored and shared
iews on a litany of issues between970 and 1985: food stamps; Specialupplemental Nutrition Program foromen, Infants, and Children; child
utrition; Older Americans Act; foodafety; nutrition labeling; consumerducation; poverty; hospital rules;ealth insurance; and nursing home
aws and rulemaking were within thessociation’s sights. But monitoring
egislation and effectively participat-
igure. The American Dietetic Association wit
ng in legislative and regulatory pro- s
esses to reflect members’ interestsften proved to be distinct goals.In 1985, ADA’s Board of Directors
pproved the establishment of a three-erson Washington, DC office (4). Thisrrangement allowed daily participa-ion in policy and program processes,n-person and continuous advocacy,nd the opportunity for ADA to rou-inely interact with other groups work-ng on food, nutrition, and health is-ues. In-house government relationsrograms made it possible to drawember leaders and association execu-
ives together in effective strategic rep-esentations. It meant that affiliatesad their own staff members to turn toor assistance. And a national advocacyrogram could support an annual leg-slative symposium to train memberso operate within a strategic, coordi-ated advocacy program (5).
NEW ERA OF STATE WORKy the early 1990s, the great progressn dietetic licensure stalled in manytates, as new thoughts about the rolef government in regulating healthare took hold. A handful of governorsepeatedly vetoed dietetics licensure inheir states on the grounds that regu-ation of registered dietitians wasostly and provided little value to tax-ayers.Coincidently, ADA decided to mar-
hal its resources to address its largestrofessional grievance—the absence ofutrition in Medicare. Despite decadesf effort, ADA could not break intoedicare through executive action or
egislation. There was great need forhe affiliate’s resources, the LNCs, therassroots networks, and professional
resident Coolidge at the White House in 1928
taff in the campaign for Medicare f
December 2008 ● Journal
edical nutrition therapy. Activism inDA advocacy soared.But the diversion of attention toedical nutrition therapy underminedember involvement in state issues.hen a task force looked at affiliate
dvocacy in 2004, they found enormousttrition in state issues. Only a fewtates held Legislative Days, and fre-uently affiliates sent students—notorking members—to these events.he task force found states operatingt burnout pace on too many issues andewer members willing to take on theoles of the LNCs (5).
Leadership development, grass-oots training, and a renewed focus ontate advocacy efforts to enlarge pro-essional opportunities for food andutrition professionals were needed,he task force said. Affiliates shouldave no more than five issues. Andffiliates need to return to the prac-ice of scheduling plenary sessions onolicy to help their members navigateffectively on their own career paths.
RESENT FACETS OF ADVOCACYoday, the old legislative symposium isDA’s Public Policy Workshop (PPW),hich usually brings about 500 ADAembers for grassroots training and
ducation on Washington’s food, nutri-ion, and health agenda.
Besides giving attendees the chanceo learn and share what they learnedith their Representatives and Sena-
ors on Capitol Hill, PPW has lessonsor state, local, and facilities work. AtPW, members learn about a commit-ent to action, alliance building, and
rainstorming for new ways to affectublic policy. PPW is a training ground
or emerging leaders, as well as a set-of the AMERICAN DIETETIC ASSOCIATION 1989
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PUBLIC POLICY NEWS
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ing for engaging public policy discus-ions for more experienced leaders.
Grassroots training and a focus ontate issues continue to be a part ofhe program. A new grassroots pro-ram has renewed support for licen-ure issues in a new era where stateegulation is no longer discredited.
Today, the revised grassroots pro-ram includes an emphasis on affiliateeadership training and communica-ion. Included in the revised programre two new positions for affiliate pub-ic policy work, the Public Policy Coor-inator and the State Policy Represen-ative.
There are increased communica-ions with affiliate public policy lead-rs and affiliate presidents, includingonference calls and special informa-ion tied to ADA Action Alerts. ADA’s
ashington office holds meetingsith every affiliate at the Food & Nu-
rition Conference & Expo, bringingheir leaders together to share infor-
ation and insights with ADA’s leg- d990 December 2008 Volume 108 Number 12
slative and Public Policy Committee,hich oversees all of ADA’s strategicolicy work. There is a new outreacho affiliate presidents for more train-ng on their public policy role in theffiliate.ADA also is returning to its advo-
acy roots. Some 35 years later, theDA Board of Directors has approvedew regional training workshops, es-ablished primarily for public policyeadership training to build commonkills and ongoing capabilities for di-titians to have their say on food, nu-rition, and health matters.
Increased opportunities for statedvocacy training will help ADA’s af-liates be successful in increasingheir visibility and influence. Therassroots framework, which includesn emphasis on speaking with oneoice across the nation, makes it pos-ible to get more resources in theands of member-advocates, makinghem stronger players in the public
iscourse of their states. The syner-ies of more than 68,000 memberscting separately and together posi-ions ADA to continue its role influ-ncing public policy.
eferences. Reinsel J. The Evolution of Programs.
Farm Programs Web site. http://grandpa-rdr.blogspot.com/2007/04/evolution-of-programs.html. Accessed September 23, 2008.
. PHS Dietitians and Nutritionists History.Center for Food Safety and Applied NutritionWeb site. http://vm.cfsan.fda.gov/�phsnutr/history.html. Updated September 2006. Ac-cessed September 30, 2008.
. The United States Senate Committee on Ag-riculture, Nutrition, and Forestry 1825-1998:Chapter 5: War, Peace, and Prosperity: 1940-1959. US Government Printing Office Website. http://www.access.gpo.gov/congress/senate/sen_agriculture/ch5.html. AccessedSeptember 30, 2008.
. Nutrition Policy Task Force, American Die-tetic Association. Discussion Paper on Food,Nutrition and Health Policy. March 2002.
. Task Force on State Food, Nutrition andHealth Policies, American Dietetic Associa-
tion. Final Report on State Issues. January2004.