Welcome to the Step Two Policy Project
An Introductory Essay from our Chairman
There is a famous New Yorker cartoon in which two mathematicians are standing in front of a blackboard looking at columns of equations which are separated by the statement “then a miracle occurs.” One mathematician says to the other, “I think you should be more explicit here in step two.”
The most important part of my job over the last 18 years working in policymaking in New York State government and politics was trying to “be more explicit in step two.” One of the things I wanted to do when I left State government was to create a small think tank that would try to contribute to solving policy problems large and small by “being more explicit in step two.”
When I retired from State government in May 2023, I created the Step Two Policy Project (“Step Two”) as a not-for-profit 501(c)(3) organization to focus primarily on policy issues involving health, behavioral health, and human services in New York State. Although a number of not-for-profit policy organizations in New York focus on healthcare policy, they generally do not seek to leverage their efforts by explicitly connecting their insights to specific policy proposals that could be implemented by New York State government. Our plan at Step Two, leveraging our subject matter expertise and experience, is to propose policy reforms that would represent tangible progress, if not always a complete solution, to multifaceted problems. The premise of Step Two’s work is that by explicitly connecting research insights to specific State policy proposals, we can have outsized leverage in producing results.
We are starting out with a small but capable team. Sally Dreslin, the Executive Director of the Step Two Policy Project, is a registered nurse who entered government in 2013 after almost 20 years of clinical practice, nursing education, and advocacy. Sally started in New York State government as the Assistant Secretary for Health in the Governor’s Office in 2013, and in late 2014, she became the Executive Deputy Commissioner at the Department of Health. In mid 2020, Sally transitioned to the Office of Mental Health (OMH), serving initially as a Special Advisor and then as the Director of Operations in the Office of the Chief Medical Officer. She left OMH in late 2022 to help lay the foundation for the Step Two Policy Project. Sally will soon be joined by a Senior Policy Fellow with policy experience in State government and other settings.
I came to New York State government and politics after a 25-year career in the private sector on an as a lawyer, an investment banker, and as the chief financial officer of Ann Taylor Stores Corporation and Priceline.com. I started as the policy director in the gubernatorial campaigns of Eliot Spitzer in 2005 and became his Director of the Division of the Budget in 2007. I became the Director of State Operations at the beginning of 2008 and continued in that role until the end of Governor David Paterson’s first legislative session. I worked for Andrew Cuomo on policy matters in his 2010 campaign for governor and served as the Director of Agency Redesign under Governor Cuomo from 2011-2013. In 2015, I became the Deputy Secretary for Health and Human Services and served in that role until 2020 when I continued my work on health policy as a Senior Advisor to the Commissioner of the New York State Department of Health.
While the work of Step Two will cover a wide range of programmatic issues related to Health and Human services, the common guiding principles and objectives that guide our work will be as follows:
Secure incremental progress: We share the view that the measure of being a progressive is the achievement of real progress. My observation is that many good ideas that would represent incremental progress don’t get implemented. Sometimes this is because State agencies simply lack the bandwidth to fully develop and implement the idea. In others, there is insufficient political focus to overcome the combination of inertia and opposition from a special interest that benefits from an inefficient status quo. Our belief is that more proposals that will result incremental progress can be enacted and implemented if backed by focused effort, a fact-based and persuasive analysis demonstrating the programmatic benefits of the proposal, combined in certain cases with an advocacy push to overcome inertia and parochial opposition to change.
Think outside the box on deep structural challenges: The State’s largest challenges often require a new paradigm to cut the Gordian knot of seemingly intractable problems. Our belief is that we can contribute to the policy debate by thinking outside the box to develop ambitious solutions, even if it takes time for a consensus to build in support of new approaches. Just laying out the facts and making an empirical case for a new paradigm can prove valuable in and of itself.
Demonstrate financial sustainability: Effective and actionable policy proposals must be grounded in financial sustainability. A major focus of the Step Two Policy Project will be to demonstrate that its policy proposals meet the test of financial sustainability. Healthcare affordability, on the one hand, and access and financial sustainability of the healthcare delivery system, on the other hand, are two sides of the same coin.
Democratize the availability of health data, information, and analysis: Our belief is that data transparency, which in turn enables the development of useful health information and the democratization of policy analysis, is an indispensable element of improved public policy and better functioning of the healthcare delivery system. Critical data about healthcare delivery in New York is often opaque, which makes it difficult for both policymakers and outside analysts to diagnose systemic problems and design effective solutions. Step Two can contribute to this goal of democratization of analysis through transparency and availability of useful health information by developing a roadmap for reform. We will also make sure that our own analyses offer as much transparency as possible about the data and assumptions being used.
We know that the State faces enormous challenges in healthcare, behavioral health, and human services such that even small improvements can benefit thousands of people while larger changes may impact hundreds of thousands or even millions of New Yorkers. We also believe that the power of ideas is an underrated tool in politics and government. With these facts as the inspirational context, the Step Two Policy Project will bring sharp focus to developing good programs and accelerating their implementation while also adding new ideas to the policy debates about solutions for our most challenging problems.
We look forward to joining the conversation among interested New Yorkers, both inside and outside of government, who strive to make government programs work better for people. We will be posting white papers and other policy proposals on our website steptwopolicy.org, as well as on Substack. Our first white paper, called “Democratization of Health Data, Information and Policy Analysis”, will appear soon. Please let us know if you would also like to receive emails with our work product.
- Paul Francis
Chairman and Founder of the Step Two Policy Project