by Erin Haley-Hitz, RDH, BSDH, MS, FADHA, MAADH
January 13, 2025

Policy plays a vital role in shaping legislation, guiding legal frameworks, and influencing nearly every aspect of society. Understanding how policy drives legislation and becomes enacted law and the time it takes for this process can reveal the complexities of enacting meaningful change. Let’s explore the stages of this transformation and what determines its timeline.

Defining Policy and Legislation

Policy refers to a structure framework of principles designed to guide decision-making with the aim of achieving specific objectives. It can be developed by various entities, including government agencies, non-governmental organizations, think tanks, and advocacy groups such as ADHA.¹ Policies serve as blueprints to address societal needs, seek solutions to pressing issues, or propose standards for behaviors and practices. For instance, ADHA’s policy manual guides its strategic work and influences discussions at the state-level as well.²

Conversely, legislation consists of laws enacted by governing bodies, such as parliaments or congresses.³ Laws codify policy into enforceable rules and rights that shape the behavior of citizens, businesses, and institutions. While policy is the blueprint, legislation is the binding legal structure built from that design.

The Policy-to-Legislation Process

The transformation of policy into enacted law involves a multi-step process that typically unfolds over months or even years. The development of regulations around local anesthesia administration and dental therapy practice are good examples of this work.

Key stages include:

1. Problem Identification and Policy Formulation

The initial stage involves identifying a societal issue that requires attention. This phase can be triggered by research, public demand, or crises. Policymakers and stakeholders gather data, consult experts, and review existing frameworks to fully understand the problem’s scope.⁴ Once defined, policy recommendations are developed to propose solutions for the identified problem.⁵

2. Stakeholder Engagement and Public Consultation

The creation of effective policy involves the input of all stakeholders, including advocacy groups, industry leaders, and the public. This step is essential for identifying potential challenges, gauging public sentiment, and refining policy proposals.⁶ Through town hall meetings, formal comment periods, and focused discussions with industry representatives, policymakers gather crucial feedback that helps identify potential pitfalls, understand public attitudes, and strengthen their proposals.

Public engagement can be time-consuming, depending on the policy’s scope, complexity and the number of interested parties. For instance, healthcare reform policy might require significant consultation due to how many groups have a stake in the outcome.⁷

3. Drafting Legislative Proposals

Once a policy has been refined through research and public input, it is time to draft legislative proposals. Legal experts and legislative specialists collaborate to create a bill or resolution that captures the policy’s intent in clear, enforceable terms. This stage requires careful wording to ensure the proposed law is comprehensive, precise, and legally sound.⁸

Legislation can unfold over weeks or months, as legal language must be meticulously reviewed to minimize ambiguity and potential loopholes that could undermine the law’s effectiveness.⁹

4. Legislative Review and Debate

Once a bill is introduced to lawmakers, it undergoes a rigorous review. Special committees may be formed to assess the bill’s content, analyze its potential impact, and suggest amendments. This phase involves intense scrutiny and debate, often requiring multiple readings and committee reports.^10,11

Legislative review is where the policy’s objectives are tested against political, economic, and social considerations. This part of the process can stall for months or even years if the proposal is contentious or if partisan gridlock ensues. This work is also affected by how often a legislative body convenes for meetings. In some states, legislative sessions occur only every two years, stalling the work even further.^10,11

5. Voting and Approval

Following the review, the bill is brought to the legislative chamber floor for debate and votes. If it passes one chamber (e.g., House of Representatives), it typically moves to the next (e.g., Senate). Both chambers must approve the bill, often through multiple rounds of negotiations and amendments.

Voting can happen quickly or be delayed due to legislative priorities, pressure from lobbying efforts, or opposition tactics. Complex or divisive bills may require extensive negotiations to win bipartisan support.^12,13

6. Enactment and Implementation

If a bill passes both legislative chambers, it moves to the executive branch for final approval. Here the head of government – president, prime minister or governor at the state level – reviews and signs the bill. Once signed, the bill becomes law.¹²

Implementing the new law involves establishing the necessary regulations, guidelines, and enforcement mechanisms. Depending on the new law’s scope, this phase can take anywhere from a few months to several years. Agencies may need to draft detailed rules, set up monitoring systems, and allocate resources to ensure compliance.^14,15

Factors Affecting the Timeline

The path from policy to enacted law follows no fixed timeline. The speed varies widely based on the complexity of the issue and the motivation of the lawmakers and the influence of the interested groups. Public pressure can either stall or expedite this work, and economic factors can accelerate it. Above all the inherent slowness of the bureaucratic process itself, and the constant competition of priorities faced by lawmakers tend to dictate the pace of progress.^14,15

Conclusion

The journey of policy to law is complex and influenced by many factors. Some policies move quickly powered by urgency or broad political alignment, while others face a slower journey due to their complexity, partisanship, or procedural challenges. This reality emphasizes the need for patience, sustained advocacy, and public engagement to drive lasting, meaningful change.

Making an impact in this process starts with supporting advocacy organizations. While everyone hopes for quick results, they are not always possible. Advocacy work is time-consuming and requires long-term commitment. It is crucial to stay connected, ask questions, and actively participate as an advocate and stakeholder to help share the policies that will become tomorrow’s laws. Joining ADHA, dental hygienists can add their voice to the collective effort, stay informed about developments, and participate in the ongoing push for change.

Advocacy is not a one-time effort but requires sustained involvement and support, not occasional participation when it’s convenient. Dental hygienists must lead discussions about their own profession, and this can only happen with the support of our professional association. We have an ethical obligation to get involved and let our collective dental hygiene voice be heard and influence policy. This is not about a one-time gesture to join. It’s about making a long-term commitment – renewing our membership year after year, staying engaged, and working together to protect both the public and our profession’s future.

Join ADHA or renew your membership today to help support the dental hygiene profession.

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References:

¹Anderson, James E., Public Policymaking: An Introduction (Cengage Learning, 2014).
²American Dental Hygienists’ Association, “ADHA Policy Manual” (October 2024), https://www.adha.org/about-adha/policies-bylaws/.
³U.S. Congress, “How Laws Are Made and How to Research Them,” accessed November 13, 2024, https://www.congress.gov/.
⁴Kingdon, John W., Agendas, Alternatives, and Public Policies (Pearson Education, 2011).
⁵Centers for Disease Control and Prevention, “Policy Process,” accessed November 13, 2024, https://www.cdc.gov/policy/polaris/policyprocess/index.html.
⁶Rowe, Gene, and Lynn J. Frewer, “Public Participation Methods: A Framework for Evaluation,” Science, Technology, & Human Values 25, no. 1 (2000): 3-29.
⁷U.S. Environmental Protection Agency, “Public Participation Guide,” accessed November 13, 2024, https://www.epa.gov/international-cooperation/public-participation-guide.
⁸Legal Information Institute, “Legislative Drafting Principles,” accessed November 13, 2024, https://www.law.cornell.edu/.
⁹Congressional Research Service, “The Legislative Process,” accessed November 13, 2024, https://www.crsreports.congress.gov/.
¹⁰Oleszek, Walter J., Mark J. Oleszek, Elizabeth Rybicki, and Bill Heniff Jr., Congressional Procedures and the Policy Process (SAGE Publications, 2021).
¹¹National Conference of State Legislatures, “Legislative Process in the States,” accessed November 13, 2024, https://www.ncsl.org/.
¹²Mazmanian, Daniel A., and Paul A. Sabatier, Implementation and Public Policy (University Press of America, 1989).
¹³Office of the Federal Register, “The Rulemaking Process,” accessed November 13, 2024, https://www.federalregister.gov/.
¹⁴Mayhew, David R., Congress: The Electoral Connection (Yale University Press, 2004).
¹⁵Baumgartner, Frank R., and Bryan D. Jones, Agendas and Instability in American Politics (University of Chicago Press, 2009).

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This article was authored by 2024-2025 ADHA President Erin Haley-Hitz. In Erin’s more than 30-year dedication to ADHA she has held leadership roles on the student, local, state and national levels of the organization and worked on advancing various legislative initiatives that strengthen the dental hygiene profession. To reach ADHA leadership email [email protected].