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Health Policy Decision Tree: Federal, State or Local

To decide which level(s) of government can help with your problem:

Answering this question may involve some research. For help, go to research tips for the decision tree.

Did you learn about your issue from a government notice or a letter  that referenced a government program, e.g. a notice from the HUSKY program or Medicare about your benefits, a letter from your doctor about provider fees in Medicaid, a news report about state plans for a health care program?

Is your issue related to one of these programs/areas? These are general guidelines and the lines of accountability get fuzzy at times.

New Congressman William Hughes of New Jersey held a town meeting to keep in touch with people back home. He explained that he is a federal legislator, "I don't take care of your potholes, I don't pick up your trash." A woman asked a question about why her trash wasn't being picked up on the day it was supposed to be and dogs were getting into it. He explained, "You know madam, as I indicated to you, I'm a federal legislator. I work on the federal budget and national issues. And what you should do is contact either your mayor or your local commissioner of public works." Without a hint of sarcasm, the woman looked her hot new Congressman directly in the eye and said, "I didn't want to start that high."

-- Hardball by Chris Matthews


If Your Question is about:   The program is:
Medicare   Federal
Medicaid   State
Managed care   Private with either state or federal oversight
Public health   All three, start with state
Veterans’ health   Federal
Consumer protection   Start with state
Uninsured   Start with state
Prescription drug coverage   Start with state
Long term care   State
Hospitals   State regulation
Mental health or substance abuse   Probably state
Insurance   State regulation
Home care   State regulation
Environmental health   Start with state
Health care guidelines   Federal and private
Schools and school-based health   Local and state
Health care for persons with disabilities   Start with state
Minority health issues   State, federal
Professional practices in health care   State regulation

This is only a partial list - if your area is not included in one of these topics, go to Research tips for the decision tree.

If your issue is federal, some resources to help are:

Called your elected officials - even if this is not about a vote, their offices can be exceptional resources in navigating governmental systems

Connecticut's US Senators:

To find your US representative, go to

Also, check the US government portal for information, First Gov

If your issue is local - contact your city or town executive offices - Mayor, First Selectman, School Superintendent contact your local legislative representative(s) - City Council, Alderman contact your local or regional health department

The numbers are in the blue pages of your phone book and/or find your Connecticut municipal government on-line at

For state issues -- Go to back to Decision Tree Question 4


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