PAF 101

1. Module 5, Lecture 8 PAF101 "Don't make the perfect the enemy of the good.” -Prof. Donald Dutkowski

2. Class Agenda • Announcements • Community Service forms are due today! • Review of Module #5 Paper • Exercise 11.1 and Memo

3. Extra Credit Extra Credit Speaker Online forms due 4/25 by 8pm 15 points possible – Up to 3 points a submission

4. Competition Points Winners Losers Competition Points as of 4/21/2014

5. Receipts Needed on Final Paper 10 points at risk! • Post Test- attach the receipt directly behind the cover page of module 5 • You will receive an email with the URL for the course evaluation, once completed print off the confirmation page and attach it behind the post test receipt

6. Prince Analysis Steps Identify Necessary Actions Identify Key Players Estimate Position (-5 to +5) Estimate Power (1 to 5) Estimate Priority (1 to 5) Calculate Probabilities Formulate Prince Strategies Ex. 9.1 Ex. 9.2 Ex. 9.3 Ex. 9.4 Chapter 10

7. Hints for Prince Analysis - 9.1B: players for legislative actions = legislature + top executive. For schools it is the school board that is the legislature. Groups of lobbyist can be players - 9.1D: budget decisions are usually administrative - 9.2: always include person with veto power, state legislature (House and Senate), and maybe lobbyist groups (but don't use the word lobby/lobbyist!)        - choosing a player is based on POWER; justification should reflect power - 9.3: justification for SCORE, not player choice - 10.2: no arguments (don’t use the word lobbying!) - 10.3B: use same guidelines as in 9.4B

8. Exercise 11.1 • Worth 40 points

9. Exercise 11.1 • Exercise 11.1 Policy Memorandum Based on What You Have Learned this Semester Your Total Score:_____ (Maximum: 40 points) • Write a policy memo of no more than 350 words. Read the Policy Memo section of Chapter 11 and follow the guidelines closely.

10. SURPRISE COMPETITION! • Groups need to find mistakes • Get out your directions from the module to follow along

11. Memo Debriefing TO: Joanne Mahoney Onondaga County Executive SUBJECT: Implement a Syringe Exchange Program in Onondaga County

12. Revised TO: Joanne Mahoney Onondaga County Executive FROM: Ryan Gerecht, EMT-D SUBJECT: Implement a Syringe Exchange Program in Onondaga County

13. Societal Problem: Dear Joanne, Societal Problem The Oneida County Health Assessment published in 2010 reports that the total number of AIDS cases among residents of Oneida County has consistently increased between 2000 and 2010. The Centers for Disease Control and Prevention report that there is no cure for the disease resulting in a 100% mortality rate.

14. Revised Societal Problem The Onondaga County Health Assessment published in 2010 reports that the total number of AIDS cases among residents of Onondaga County has consistently increased between 2000 and 2010. Nearly 40% of these cases are a result of intravenous drug users sharing contaminated syringes which results in the transmission of HIV. The Centers for Disease Control and Prevention report that there is no cure for the disease resulting in a 100% mortality rate.

15. Proposed Policy: Proposed Policy Since 1992, free and anonymous syringe exchange programs (SEPs) have been legal in the state of New York. Since that time seven New York cities or boroughs have established at least one SEP, each with great success.

16. Revised Proposed Policy The Onondaga County Health Department will establish free and anonymous syringe exchange programs (SEPs) that would provide sterile syringe and other necessary sterile injection accessories, in accordance with the already established New York State Department of Health guidelines governing SEPs. Additional resources are required to implement this policy.

17. Benchmarks: Benchmarks National researchers at both the CDC and the University of California have shown SEPs to reduce HIV infection rates by nearly 50%. Similar results have been reported for New York State. Assuming implementation in 2014, the percentage of HIV infections from intravenous drug use should decrease to 28% in 2016 and 14% in 2018, and 7% in 2020. This will result in a 7% annual decrease in infection rate.

18. Revised Benchmarks This policy will be able to be implemented quickly; however, it will take time show the effect on the number of AIDS cases. Therefore, the benchmarks for this policy will be set at 5, 10, and 15 years from the date of the SEP opening. National researchers at both the CDC and the University of California have shown SEPs to reduce HIV infection rates by nearly 50%. Similar results have been reported for New York State. Assuming implementation in 2014, the percentage of HIV infections from intravenous drug use should decrease to 28% in 2019, 14% in 2024, and 7% in 2029. This policy would be proved effective if these benchmarks were reached, resulting in a significant reduction of AIDS cases in Onondaga County.

19. Political Feasibility: Political Feasibility According to the Centers for Disease Control and Prevention the cost per HIV infection prevented by SEPs is between $4,000 and $12,000, considerably less than the estimated $190,000 spent in treating a single person infected with HIV. Upon approval by the AIDS Institute and the NYS Health Commissioner, state and federal funds cover most of the costs. The financial pressure on the county budget would create substantial political opposition to the policy. Sincerely, Ryan Gerecht, EMT-D

20. Revised Political Feasibility This policy has a medium feasibility. There will be initial opposition to this policy because of tight budgetary conditions and demands for other programs.  However, the program has a relatively small price tag and strong support from the Department of Health should be enough to allow the approval of the program especially the reports indicate the high cost of treating aids patients. (313)

21. For Next Class • Finish Exercises 9.1-9.6 by next class. • Read Chapter 10 and first part of Chapter 11 in Maxwell Manual http://classes.maxwell.syr.edu/paf101