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State Legislation Concerning Individuals With Dementia

An Evaluation of Three Theoretical Models of Policy Formation

^a Department of Health Management and Policy, University of Iowa, Iowa City
^b Andrus Gerontology Center, University of Southern California, Los Angeles

Correspondence: Brian Kaskie, PhD, Department of Health Management and Policy, University of Iowa, 2700 Steindler, Iowa City, IA 52242-1008. E-mail: brian-kaskie{at}uiowa.edu.

Laurence G. Branch, PhD

Purpose: This study examined the formation of state government policies concerning persons with dementia. In particular, we identified variables associated with the passage of pertinent state laws by testing three theoretical models of policy formation: the iron triangle, the policy system, and an integrated model. Methods: We sampled 44 states and counted the number of laws concerning individuals with dementia that passed during the 1998 legislative sessions. We constructed nine independent variables to represent the three theoretical models of state policy formation. Then the number of legislative actions were regressed onto each model. Results: The integrated model that consisted of political actors, legislative features, and environmental inputs met goodness-of-fit criteria for a maximum likelihood regression analysis (²/df = 1.55). The advocacy effort of the Alzheimer's Association, number of legislative champions, supply of special care beds for persons with dementia, and recent policy activity were related significantly with increased legislative activity concerning individuals with dementia. Implications: Policy responses concerning persons with dementia increasingly have been created within state governments, and we identified variables associated with the passage of pertinent state laws. This research also contributed to the advancement of comparative state policy research by contrasting the three theoretical models of policy formation.

Key Words: Alzheimer's disease • Public policy • State governments

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