RESULTS IN BRIEF
The State's Department of Health Services (department), which develops research on health-related issues as part of its effort to protect and improve the health of Californians, has not established policies or procedures to guide its decisions about whether, how, and when to publicize the results of this research. Nonetheless, our review of 10 studies commissioned or completed by the department during fiscal years 1997-98 and 1998-99 showed that even though such guidelines are absent-and despite criticism by legislators, the media, and citizens-the department has not withheld study findings inappropriately. Not only is most of its information available upon request under the Public Records Act, but the department also has the authority to determine exactly how it will use the health information it acquires. Moreover, the department takes specific positions on certain health issues; sometimes by choice, but other times as required by statute, such as it does when advocating against smoking among Californians. These positions naturally guide the department's managers when they decide whether to release information to the public, to supply the data to specific groups, or simply to use the information as a tool for developing and evaluating the department's programs and educational materials.
During the last year or so, the department has faced criticism about its decision not to release data from a survey of bar owners and employees that showed their general lack of support for California's 1998 ban on smoking in bars. In reviewing this and other studies, we concluded that the department's decision not to disclose the survey results to the general public was consistent with the original purpose for this survey and that the department apparently did not intend to deprive the public or Legislature of information. Because the law requires the department to discourage tobacco use in California, and because the goal of the study was to provide data to programs within the department itself, management and staff instead used the results in an educational program aimed at bar owners and employees. Further, it appears that the department's distribution of a press release announcing widespread public support for the smoking ban in bars, an event that occurred just five days before a legislative hearing on a bill to reverse the ban, was not an attempt to influence legislative decision making.
On the other hand, its lack of policies about study distribution continues to leave the department open to allegations that management has held back or timed improperly the release of information that may interest the general public. Even though the department has a policy that requires the director's approval for documents prepared for public dissemination, the policy is effective only after a manager has chosen to publish research findings. The department does not give managers guidelines for deciding which studies they should propose for public release, so inconsistent decisions among managers could occur. Further, managers have not always followed existing policy and sought approval from the director for studies they plan to make public.
The department is also vulnerable to charges that it is with-holding information simply because it does not publicize the existence of information that the public can request. For example, of the 10 studies we examined, 6 went to limited audiences or did not go beyond the department but were available upon request. However, the general public probably does not know that these 6 reports exist. By developing a list of studies, surveys, polls, and research results that are available to the public, and by publishing this list in an accessible location, such as its Web site, the department could avert future controversies about the availability of its research.
Finally, the department could prevent controversies about the way it schedules the distribution of information if it were to publish the results of studies promptly after researchers have completed their work. For two studies we reviewed, the department unnecessarily delayed for various reasons its publication of the research data. Publication of one of these studies, involving hazardous radon levels in schools, awaited approval of a supplementary report by the department and by the Health and Welfare Agency, now called the California Health and Human Services Agency (agency). This agency then waited to release the radon analysis until after California's new administration took office in January 1999. Because of delays at both the department and the agency, the study did not become public until almost one year after its completion. This type of postponement reduces the information's effectiveness and may defer preventive action that should take place as soon as possible.
Because the health-related information it obtains can be vital to Californians and concerns important issues ranging from prenatal care to occupational disease, the department needs to develop a strategy for distributing its findings to the widest appropriate audiences. In designing this strategy, the department should design classifications for its information that correspond with levels of release, and it should establish policies that guide its managers to use the classifications consistently as they determine whether, how, and when to release departmental information. The classifications for information should include at least these categories:
The department agrees with the report's conclusions and states that it will review its policies and procedures to determine how it might improve the timely dissemination and accessibility of public information.