State legislative staff influence in health policy making

State legislative staff may influence health policy by gathering intelligen ce, setting the agenda, and shaping the legislative proposals. But they may also be stymied in their roles by such institutional constraints as hiring practices and by turnover in committee leadership in the legislature. The intervening variable of trust between legislators and their support staff i s also key to understanding influence and helps explain how staff-legislato r relationships play an important role in designing state health policy. Th is study of legislative fiscal and health policy committee staff uses data from interviews with key actors in five states to model the factors importa nt in explaining variation in the influence of committee staff on health po licy.