POLI 457: Health Care Policy

Fall Semester 2016

Room: HOL 317

Mondays and Wednesdays 11:00am – 12:20pm

Professor Greg Thorson Office: Hall of Letters 306

Phone: (909)748-8636 Office Hours: Mondays (2:00pm -3:00pm),

Email: Greg_Thorson@redlands.edu Fridays (10:00am – 11:00am), and

Web Page: http://bulldog2.redlands.edu/fac/Greg_Thorson/ by appointment

Since the presidencies of FDR and Harry Truman, health care has been one of the most important public policy issues in American politics. Over the past eighty years, a sizable percentage of Americans have traditionally held deep concerns about both the limited access to and the high cost of health care. Yet while many Americans believe that the health care system needs major changes, there is little consensus as to what the appropriate solutions are. Complicating the matter even further, many people find the issues in health care policy to be extraordinarily complex.

In this class, we will examine each of the major U.S. federal health care programs (Medicare, Medicaid, and SCHIP) to determine why each program was created, how each evolved, and what impacts each has had on the American health care system. Second, we will examine the cost-effectiveness of the system. Do Americans get their money’s worth out of their health care system? Third, we will examine recent reforms that have been proposed and/or enacted at both the state and federal level including the Affordable Care Act (e.g. Obamacare). What have been the effects of these reforms? Finally, we will examine how other countries have constructed their health care systems. Should Americans look elsewhere for solutions to their health care system?

Because the history of American attempts to reform the health care system has been necessarily intertwined with changes in the broader political landscape of American politics, we will spend some time at the beginning of each class reviewing major developments both in health care policy specifically and American politics generally.

The Kaiser Family Foundation is an excellent provider of health policy news. Students are required to subscribe to the free Kaiser Health News Daily Health Policy Report. To subscribe, go to:

http://www.kaiserhealthnews.org/daily-report.aspx

Select the Email Sign-Up tab on the right hand side of the page (about halfway down).

Complimentary copies of the New York Times, the Los Angeles Times, and the USA Today can be found throughout the campus. Please read a major, nationally recognized news source on a daily basis, and be prepared to talk about the key political developments each day in class.

I also recommend that you follow these news organizations via Twitter and/or Facebook.

Professor Thorson’s Favorite Facebook “Likes”

News	Washington DC	Health Care	Think Tanks	Periodicals
Washington Post	Roll Call	Kaiser Family Foundation	Brookings Institution	The Economist
Los Angeles Times	Politico	Health Affairs	Mathematica Policy Research
PBS Newshour		The Commonwealth Fund
		Journal of Health Politics, Policy, and Law
		Robert Wood Johnson Foundation

Professor Thorson’s Favorite Twitter Feeds to “Follow”

National News	State and Local News	Washington DC	Health Care	Think Tanks
Los Angeles Times	Sacramento Bee	Politico	Kaiser Health News	Brookings
Post Politics (Washington Post)	California Politics	Roll Call Politics	RWJF News	AEI
CNN Breaking News	Capitol Alert			CATO Institute
NPR Politics	KPCC
	Redlands Daily Facts

Course Description:

Examination of the U.S. health care system, including the evolution and impact of Medicare, Medicaid, and the SCHIP programs. Comparison of effectiveness of the U.S. health care system with other systems around the world. Examination of recent attempts to reform the U.S. health care system and their likely impacts.

Course Outcomes

Students who complete the class should demonstrate:

a) a thorough knowledge of how the major U.S. federal health care programs (Medicare, Medicaid, and SCHIP) work,

b) how cost effective the U.S. health care system is in comparison to other health care systems in the world, and

c) an understanding of recent attempts (both federal and state) to reform the U.S. health care system

Additional Public Policy Major Expected Program Outcomes

Students completing this Public Policy Capstone should also:

a) Demonstrate mastery of knowledge about public policy issues and approaches by summarizing and evaluating existing literature in the field.

b) Apply a range of relevant theories, concepts, and approaches taken from the social sciences, humanities, natural sciences, and ethics to the critical analysis of public policy problems.

c) Demonstrate knowledge about the feasibility of solving complex social problems within the context of existing political and economic institutions and processes.

d) Use appropriate quantitative and/or qualitative methods to systematically analyze public policy issues.

e) Examine the ethical implications of proposed or existing public policies.

f) Formulate appropriate, targeted responses to public policy issues.

g) Communicate knowledge effectively through verbal and written forms.

Course Delivery Model

Students are responsible for their own learning and growth in the class. To assist students, I have selected outstanding articles from the field. It is the responsibility of the student to come to class each day fully prepared to discuss the content of the articles as well as to share critiques and/or opinions about each article. I see my primary role as a facilitator. While I will have some questions prepared for each class session, discussion will primarily be led by students.

Exams

Both exams will be closed book and closed note. Each exam will be composed of predominantly essay questions. I will provide you with a review sheet for each exam to assist you in your preparation. The midterm exam will last 80 minutes. The final exam will last two hours.

Required Texts:

Brasfield, James M. 2011. Health Policy: The Decade Ahead. London:

Lynne Rienner Publishers.

Paul, Richard and Linda Elder. 2014. Critical Thinking: Concepts and Tools (7^th Edition).

Tomales, CA: Foundation for Critical Thinking.

The optional course textbook is:

Turbanian, Kate. 2013. A Manual for Writers of Research Papers, Theses, and Dissertations, 8^th

Edition. Chicago: University of Chicago Press.

Additional readings can be found on the course Moodle site.

Grades:

Daily Participation/Quizzes 25%

Midterm Exam 25%

Final Exam 25%

Paper 25% (Prospectus 1%; Outline 1%; Peer Review Draft 0%;

Faculty Review Draft 5%; Final Draft 13%;

Presentation 5%)

Course grades will be assigned using the following guidelines:

Course Percent	Grade
93%-100%	4.0
88%-93%	3.7
83%-88%	3.3
79%-83%	3.0
75%-79%	2.7
71%-75%	2.3
67%-71%	2.0
63%-67%	1.7
60%-63%	1.3
57%-60%	1.0
54%-57%	0.7
Below 54%	0.0

Grading Scales

Check System

Grade	Points
Check Plus	10/10
Check	8/10
Check Minus	6/10
Zero	0/10

Letter Grades

Letter Grade	Points Equivalent
A	10/10
A-	9.2/10
B+	8.6/10
B	8/10
B-	7.7/10
C+	7.3/10
C	7/10
C-	6.7/10
D+	6.3/10
D	6/10
D-	5.7/10
F	0/10

Make-up Exam and Quiz Policy

Make-up quizzes and exams are available only when a student has an instructor-approved reason for missing the regular quiz or exam (such as extra-curricular music or athletic events, doctor’s note, etc.). Whenever possible, both notification and arrangements for the make-up exam must be made either before the missed quiz or exam. If you miss a class period for an approved reason, you may submit a one-page summary of the reading for that day within seven days of the missed class period to earn the missed quiz participation points.

Class Participation/Quizzes:

Students will be graded on their physical presence in class as well as their participation in class discussion. Students are required to have read the assigned material before coming to class. Your participation grade will be based on your physical presence in class, the quantity and quality of your contributions to the class discussion, and the extent and quality of your preparation for class as measured by your participation in class and daily class quizzes.

Class attendance, as well as taking the quizzes, is required for completion of the course. On the first day of class I will distribute “clickers” from Turning Technologies Audience Response System. Please note both the number of your clicker and the Device ID printed on the back of the clicker. You will be responsible for picking it up before and returning it after each class session.

You will take daily quizzes that ask you about a) the main points from the previous class discussion, and b) the major points addressed in the new readings to be discussed in class that day. This use of the clickers will reward you for both attending class and for being prepared for class each day.

I will provide you with a clicker (normally priced at $51) at no charge to you that you will use to take your quizzes daily. However, you will be responsible for both creating a Turning Account and paying the mandatory subscription fee (see below).

To create your mandatory Turning Account, go to:

https://account.turningtechnologies.com/account/

Please note that you will need to buy a license to use the software. Buying a bundle or clicker is NOT necessary. There are several options for purchasing a license (pricing subject to change):

One Year: $20.99

Two Years: $31.50

Three Years: $35.00

Four Years: $37.00

I am currently the only professor using TurningPoint Cloud at the University of Redlands. I currently use the clickers in all of my on-campus classes. If you anticipate taking additional classes from me in the future, you may want to buy an extended license.

You may pay for your license with Visa, MasterCard, American Express, or Discover.

After you have registered a license, go ahead and register your assigned device. Simply add the Device ID that is printed on back of the clicker that you were assigned in class. Please complete this registration prior to the second day of class.

Finally, while I don’t formally ban the use of laptops, tables, and cell phones in class, I strongly encourage you to turn these devices off during class and use paper and pen/pencil for note-taking. There is strong evidence that this method of note-taking is far superior to that of note-taking on a screen.

Paper Requirements

You are required to write a 10+ page research page paper that thoroughly analyzes the existing academic literature published about an important health care policy topic. The paper will be graded on a 20-point scale. However, if your paper consists of original data analysis that employ large health care data sets, you can earn up to 2 additional points of extra credit on both your draft and your final paper.

The rubric that I use in evaluating the paper can be found in this syllabus. Please note that I use this rubric informally to evaluate your paper. It is not used in a mechanical way to issue a grade. There are no percentages or scoring assigned within each section. Rather, it is simply a tool that I use to communicate to students my values in grading your paper. I will return the completed rubric, with evaluations for each section, to you with your completed draft.

You have a great deal of latitude in determining your paper topic. However, paper topics must be approved by the instructor.

Previously approved topics include:

1) Describe the politics of the passage of Medicare, Medicaid, or SCHIP

2) Describe the evolution of Medicare, Medicaid, or SCHIP

3) Describe the effectiveness of Medicare, Medicaid, or SCHIP

4) Examine one or more health care system outside the U.S., such as Canada, Japan, Germany, etc. and compare them to each other or to the U.S.

5) Describe state level variation in the administration of Medicaid or SCHIP

6) Examine an aspect of implementation of the ACA (creation of exchanges, expansion of Medicaid, etc.)

7) Describe in detail a state and/or city health care reform, such as Vermont, Massachusetts, Maryland, or San Francisco

8) Examine the cost effectiveness of the American health care system

This paper is a research paper. Your primary task is to read and review all of the major research findings about your topic, and then write about your findings concisely and eloquently. I expect you to do exhaustive literature searches. You might consider meeting with a reference librarian in the Armacost Library, and searching major electronic databases, including EBSCO, ERIC, JSTOR, Lexis-Nexis, and/or Google Scholar, as well as public policy think tanks (e.g. Brookings, AEI, Rand, etc.) and health care policy organizations (Kaiser Family Foundation, Commonwealth Fund, etc. ) to produce a thorough literature review.

Furthermore, I encourage you to limit the amount of personal opinion you put into the paper. I am most interested in the summaries of your research. To what degree are the authors in agreement or disagreement? What lessons can be learned about this topic through a review of the literature?

Your paper must include a minimum of 15 academic sources in addition to those cited in class. Pay close attention to the quality of your sources. The strongest sources will be from top journals in health care policy, political science, economics, and public policy (e.g. Health Affairs, Health Economics, Policy, and Law, Journal of Policy Analysis and Management, American Economic Review, Economic Policy, Applied Economics, American Political Science Review, Journal of Politics, American Journal of Political Science, etc.), top public policy think tanks (Brookings, RAND, AEI, Heritage Foundation), top health care nonprofits (Kaiser Foundation, Urban Institute) as well as books written from the top university and perhaps law school presses (Oxford, Cambridge, Michigan, Harvard, Yale, etc.).

Papers must be written in Microsoft Word format, with a 12 point font and 1” margins. Your bibliography and citations should follow the Style Manual for Political Science as published by the American Political Science Association (APSA).

APSA’s style manual can be found on the Moodle course website and at:

http://www.apsanet.org/media/PDFs/Publications/APSAStyleManual2006.pdf

Bibliographies do not count toward the 10+ page minimum.

A two-page prospectus that outlines the thesis of your paper as well as identifies at least 10 sources that will be used in your paper is due at the beginning of class on Monday, October 31^st. The first page of the prospectus should introduce your research question as well as establish both its importance and its context within the existing literature. You must also include in the first page of your paper a clear, concise thesis statement that unambiguously states your primary research question or hypothesis. The second page of your prospectus should list at least 10 (and preferably 15-35) academic sources that you will review and cite in your paper. To find suitable references, consider using Google Scholar, JSTOR, and other resources in the Armacost Library. When using Google Scholar and JSTOR, consider finding a classic article on the topic and clicking the “Cited by” link. Many students have also found the CQ Weekly Report and the CQ Almanac to be helpful for federal policy. Both can be found in the Armacost Library.

A one-page (single-spaced) formal outline of your paper is due at the beginning of class on Wednesday, November 7^th. The purpose of writing the outline is to encourage you to make important and deliberate choices about the structure of your paper. Begin by offering a clear, precise, and succinct thesis for the paper. Next, identify the main ideas that offer support for the thesis. Finally, summarize the details that offer support for each of these main ideas. You should use conventional labeling in your outline for main ideas (I, II, III, etc.), supporting statements (A, B, C, etc.) and details (1,2,3; a, b, c etc.). All of the statements should be complete sentences that use appropriate grammar and punctuation. Cite substantive findings from specific authors as evidence for your major points. Your grade will be based on a) the thoroughness and logic of your proposed structure, and b) the clarity and succinctness of your writing.

A complete draft of your paper of the paper is due at the beginning of class on Monday, November 21^st.

Each member of the class will be assigned to a peer group consisting of two or three students. Students must bring printed copies of their completed draft for both the professor and each member of their peer group. Students will then review each of the papers for the other members of the peer group. Peer group responses are due at the beginning of class on Monday, November 28^th.

The professor will do his best to return paper drafts by Wednesday, November 30^th.

Students should make substantial revisions to the paper based on the feedback from the professor, their peers and their own evaluation of the paper. Students may schedule an optional short 10-minute conference with the professor to discuss the final recommended revisions.

A final revised draft of your paper, complete with the prospectus, outline, peer evaluations, and a copy of your PowerPoint presentation is due when you make your presentation on Tuesday, December 6^th. Students will sign up to present at a one-hour evening session on December 6^th. Students are required to actively listen to and participate in all of the presentations made during their assigned one-hour block. Students that have unavoidable conflicts with all of the evening sessions will be allowed to present during our regularly assigned class time on December 7^th.

PowerPoint Tips (see also Turabian, pp. 124-128):

1) Keep your presentation simple. Clearly and prominently present the thesis of your paper.

2) Discuss relevant research in detail, but keep track of your time.

3) Use high-quality graphics. Avoid ClipArt.

4) Use data and charts sparingly but effectively.

5) Limit the number of words and/or bullets on each slide.

6) Don’t read the PowerPoint slides verbatim.

7) Leave at least three minutes at the end of the presentation for questions. Answer each question directly and clearly.

8) Practice in advance. Be sure to time yourself.

9) Turn in paper copies of your PowerPoint along with your other paper materials (e.g. prospectus, outline, peer review, faculty review, final draft) at the conclusion of your presentation.

Be sure to complete your paper on time. Late papers will be penalized a full letter grade per calendar day.

Students are also encouraged to take advantage of the writing assistance offered by Student Services.

Accommodations for Students with Disabilities

I am happy to provide accommodations to students with disabilities. Please contact the University of Redlands Disability Services office to set up these arrangements. Disability Services can be reached at 748-8108. Disability Services has a highly trained staff that has the experience and expertise to assist students with a wide range of disabilities.

Academic Honesty:

Academic honesty stands at the center of intellectual pursuits in the academic community. All students are expected to demonstrate integrity and honesty in completion of class assignments. Faculty and student scholarship in all forms, individual and collaborative, expresses our understanding and esteem for intellectual honesty. Nurturing and sustaining a climate of honesty are the responsibilities of every member of the community. The academic policy statement includes standards of academic honesty, obligations and responsibilities of the members of the academic community for cultivating a climate of academic honesty, violations of academic honesty, and procedures for addressing academic dishonesty.

Both the quizzes and exams are closed book and closed notes. You are not to consult with any materials during either. In addition, the exams are not collaborative. You are not allowed to talk with any of your peers or look at anyone else’s exam during the exam period. Papers are to be written solely by you. Proper citation must be used whenever you are utilizing someone else’s ideas.

Scholastic dishonesty means plagiarizing; cheating on assignments or examinations; engaging in unauthorized collaboration on academic work; taking, acquiring, or using test materials without faculty permission; submitting false or incomplete records of academic achievement; acting alone or in cooperation with another to falsify records or to obtain dishonestly grades, honors, awards, or professional endorsement; altering forging, or misusing a University academic record; or fabricating or falsifying data, research procedures, or data analysis. In this course, a student responsible for scholastic dishonesty can be assigned a penalty up to and including an "F" or "N" for the course.

You are responsible for both understanding and obeying both these and other University policies on academic honesty. Academic dishonesty in any portion of the academic work for a course shall be grounds for awarding a grade of F or N for the entire course.

For the complete text of student responsibility please see the University of Redlands Catalog under Academic Standards.

Withdrawal/Incomplete:

Students are responsible for voluntarily withdrawing from the class should they decide not to complete it. If your name appears on the registrar’s final grade sheet and I can find no work on which to base a grade, I must give you an “F”. I observe all University drop deadlines.

Course Outline/Assignments (Please note this is a tentative schedule and may be adjusted at any time by the Professor):

September 7 Introductions/Review Syllabus

September 12 The Political Economy of Health Care

Paul and Elder (All)

and

Brasfield, Chapter 1

September 14 “How Has Health Spending Changed Over Time?” 2014.

Peterson-Kaiser Health System Tracker.

and

“How Do Health Expenditures Vary Across the Population?”

2016. Peterson-Kaiser Health System Tracker.

September 19 “Mirror, Mirror On the Wall: How the Performance of the U.S.

Health System Compares Internationally”. 2014.

The Commonwealth Fund.

September 21 The Health Policy System

Brasfield, Chapter 2

September 26 Medicare

Brasfield, Chapter 3

September 28 “An Overview of Medicare”. April 2016.

The Henry J. Kaiser Family Foundation.

AND

“The Facts on Medicare Spending and Financing.” August 2015.

The Henry J. Kaiser Family Foundation.

October 3 “What did Medicare Do? The Initial Impact of Medicare on

Mortality and Out of Pocket Medical Spending.” October 2007.

Amy Finkelstein and Robin McKnight. Journal of Public

Economics. 92:7:1644-1668.

October 5 Medicaid and the Children’s Health Insurance Program

(CHIP)

Brasfield, Chapter 4

October 10 No Class – Fall Break

October 12 “Medicaid Moving Forward”. June 2015. The Henry J. Kaiser

Family Foundation.

October 17 “The Impact of Medicare and Medicaid on Access to Medical

Care.” In The Role of Health Insurance in the Health Services

Sector. 1976. National Bureau of Economic Research.

Pps. 391-436.

October 19 “The Children’s Health Insurance Program: A 50-State

Examination of CHIP Spending and Enrollment”.

October 2014. The Pew Chartitable Trusts and the John D. and

Catherine T. MacArthur Foundation.

October 24 Film: “Sick Around America”

October 26 Film: “Sick Around the World”

October 31 Paper Prospectus Due

“The Impact of Medicaid and SCHIP on Low Income

Children’s Health.” February 2009. The Henry J. Kaiser Family

Foundation.

and

“The Impacts of the State Children’s Health Insurance Program

On Children Who Enroll: Findings from Ten States.” August 2007.

Health Services Research. 42:(4) 1520–1543.

November 2 Midterm Exam Review Sheet Distributed

The Uninsured

“The Uninsured: A Primer” December 2015. The Henry J. Kaiser

Family Foundation.

November 7 Midterm Exam (Moved Due to Election Date)

November 9 Paper Outline Due

Too Much Money: Uncontrolled Costs

Brasfield, Chapter 5

AND

Long-Term Care

Brasfield, Chapter 6

November 14 Health Care Reform

Brasfield, Chapter 7

AND

“Focus on Health Reform: Summary of the Affordable Care Act.”

April 2013. The Henry J. Kaiser Family Foundation.

November 16 “Focus on Health Reform: A Guide to the Supreme Court’s

Affordable Care Act Decision.” July 2012. The Henry J. Kaiser Family Foundation.

AND

Sommers, Benajamin D., Robert J. Blendon, and E. John

Oprav. 2016. “Both The ‘Private Option’ And Traditional

Medicaid Expansions Improved Access to Care for Low-

Income Adults.” Health Affairs. 35(1):96-105.

November 21 Full Draft of Paper Due (Distributed to Peer Group)

Improving Student Peer Feedback

Linda B. Nilson

College Teaching , Vol. 51, No. 1 (Winter, 2003), pp. 34-38

AND

Obama, Barack. 2016. “United States Health Care Reform:

Progress to Date and Next Steps.” Journal of the American

Medical Association. 316(5):525-532.

November 23 No Class – Thanksgiving Break

November 28 Peer Group Responses Due

How Other Countries Do It

Brasfield, Chapter 8

and

“Achieving a High-Performance Health Care System with

Universal Access: What the United States Can Learn from Other

Countries.” 2008. Annals of Internal Medicine. 148:55-75.

November 30 American State Reforms

“What Other States Can Learn From Vermont’s Bold

Experiment: Embracing A Single-Payer Health Care Financing

System”. July 2011. Health Affairs. 30:7. Pp 1232-1241.

and

“Governor Abandons Single-Payer Health Care Plan.”

New York Times. December 17, 2014.

December 5 Murray, Robert. 2009. “Setting Hospital Rates to Control Costs

and Boost Quality: The Maryland Experience.” Health Affairs.

28: 1395-1405.

and

What Can We Expect by 2021?

Brasfield, Chapter 9

December 6/7 No Class – Presentations on December 6^th from 6pm to 10pm!

Final Papers Due at Presentation

December 12 Course Wrap-Up/ Teaching Evaluations/

Final Exam Review Sheet Distributed

Final Examination:

The final exam will be held on Saturday, December 17^th from 9am to 11am or as directed by the Dean’s Office. Please mark this final exam date on your calendar ASAP. Do not plan to depart Redlands until your finals are completed!

University of Redlands*

Public Policy Program

Effective Written Communication Rubric

Student Learning Outcome:

Communicate knowledge effectively through verbal and written forms.

3=Advanced; 2=Proficient; 1=Basic; 0=Below Basic

Indicators of Effective Writing	Levels of Achievement
	Advanced (3)	Proficient (2)	Basic (1)	Below Basic (0)
Thesis/Research Question	Easily identifiable, clear and concise, insightful, and appropriate for the field of Public Policy	Identifiable, clear, and appropriate for the field	Somewhat difficult to identify, unclear, and/or slightly inappropriate for the field	Very difficult to identify, unclear, and/or inappropriate for the field
Organization	Coherent and clear, all paragraphs support thesis statement, each paragraph supports its topic sentence, excellent transitions	Mostly coherent, generally supports thesis, good transitions	Often lacks coherence, mixed support for thesis, transitions often missing or weak	Incoherent, lacks support for thesis, transitions weak and often missing
Analysis, Logic and Argumentation	All ideas progress logically from an identifiable thesis, compelling justifications are offered to support thesis, counter-arguments are anticipated and addressed, appropriate connections are made to outside material	Thesis is generally supported by logically compelling assertions and appropriate connections	Insufficient support for some arguments, assertions are vague or lack focus, support offered is sometimes irrelevant, tangential or repetitive	Lacks support for arguments, unfocused, uses irrelevant information to support thesis

Use of Evidence	Appropriate source information (typically primary) used to support thesis and buttress all arguments made in essay, excellent integration of quoted/paraphrased material into writing	Appropriate source information used to support thesis and to buttress most arguments, good integration of sources into writing	Sometimes weak use of source information (excessively secondary), inadequately supports thesis and/or sub-arguments, weak integration of quoted/paraphrased material into writing	Very weak use of source information (excessively secondary), fails to support thesis and/or sub-arguments, very weak integration of material into writing
Mechanics (Grammar, Spelling, Language Usage, Sentence Structure, Citation Format)	Excellent command of language, proper use of grammar/writing conventions, few to no misspelled words, correct word choice, excellent variety and complexity of sentence structure, uses citation format appropriate to the field of Public Policy	Good command of language, generally proper use of grammar/writing conventions, minimal misspelled words, largely good word choice, some variety and complexity in sentence structure, generally uses citation format appropriate to the field	Generally proper use of grammar/writing conventions, but with simple sentences generally lacking variety/complexity in structure, acceptable citation format	Weak use of language, poor grammar, and numerous mechanical errors undermine coherence, weak citation format

* Special thanks to Fort Hays State University Department of Political Science for developing this framework.

University of Redlands*

Public Policy Program

Effective Oral Communication Rubric

Student Learning Outcome:

Communicate knowledge effectively through verbal and written forms.

3=Advanced; 2=Proficient; 1=Basic; 0=Below Basic

Indicators of Effective Content	Levels of Achievement
	Advanced (3)	Proficient (2)	Basic (1)	Below Basic (0)
Indicators of Effective Content
Introduction: gains attention, connects to topic, establishes credibility	Creative attention getting strategy captures listeners’ attention to introduce the topic. It is relevant to the topic and clearly gains the desired response from the audience. Credibility was established by speaker.	Effective strategy to capture listeners’ attention. Adequate introduction of the topic. Credibility was established by the speaker.	Use of attention getting strategy, but did not seem to adequately capture audience attention and/ or lead to desired outcome. Credibility was implied.	No attention getting strategy was evident. No clear or relevant connection to topic or speech purpose. No credibility was established.
Thesis Statement: explicit, identifies topic, previews main points	Speaker clearly stated a well formulated thesis statement during the speech introduction. Thesis statement identifies topic and lists/previews main points.	Thesis statement identifies topic and lists/previews main points.	Thesis is implied, although not explicitly stated. Topic is clearly identified, but main points are not clearly previewed.	No thesis statement. Main points are not clearly identified, audience unsure of the direction of the message.
Connection to Audience: needs & interest, demonstrates understanding	Connection of topic to audience needs and interests is stated with sophistication. Identifies and expresses a deep understanding of their target audience.	Clearly stated the relevance of topic to audience needs and interests. Expresses an understanding of their target audience.	Topic seems somewhat relevant to audience. Vague reference to audience needs and or interests. Identifies target audience.	Topic seems irrelevant to audience needs and interests. No attempt made to connect topic to audience.

Subject Knowledge: depth of content, relevant support, clear explanation	Depth of content reflects thorough understanding of topic. Main points well supported with timely, relevant and sufficient support. Provided precise explanation of key concepts.	Main points adequately substantiated with timely, relevant and sufficient support. Accurate explanation of key concepts.	Provides some support for main points, but needed to elaborate further with explanations, examples, descriptions, etc. Support is relevant, but not timely.	Provides irrelevant or no support. Explanation of concepts is inaccurate or incomplete.
Organization: main points distinct from support, transitions, coherence	Effective organization well suited to purpose. Main points are clearly distinct from supporting details. Graceful transitions create coherent progress toward conclusion.	Clear organizational pattern. Main points are distinct from supporting details. Smooth transitions differentiate key points.	General structure/organization seems adequate. Difference between main points and supporting details is blurred. Logical flow, but no clear signposts for transitions.	Lack of structure. Ideas are not coherent. No transitions. Difficult to identify introduction, body, and conclusion.
Indicators of Effective Delivery
Eye Contact: establish rapport; expand zone of interaction	Consistently uses eye contact to maintain rapport with audience. Inconspicuous use of speaker notes. Effective use of scanning to expand zone of interaction.	Eye contact establishes rapport with audience. Unobtrusive use of speaker notes. Scanning of audience to establish a zone of interaction.	Conspicuous use of speaker notes. Only occasional, sporadic glances at audience.	Reads speech from notes/manuscript. Avoids eye contact with audience.
Movement: expressive, comfortable, enhances message	Gestures, facial expressions, and posture reinforce and enhance the verbal message. Body language is expressive, dynamic, natural and comfortable.	Body language is an adequate support of the message. Movement and gestures clarify key points. Facial expressions and posture seem comfortable.	Body language is a minimal support of the verbal message. Gestures, facial expressions, and posture reflect speaker discomfort that occasionally interferes with the message.	Body language is not supportive of the message, may contradict it. Gestures, facial expressions, and posture are stiff or distracting.

Voice: rate, pitch, volume and tone are natural and authentic	Tone is authentic and appropriate to topic. Rate, pitch and volume vary at key points to support the verbal message and keep audience interest. Voice is natural to the speaker and topic, talking with rather than at audience.	Tone fits verbal message, changing for emphasis at appropriate moments. Rate and volume allow audience to follow message. Pitch seems natural to speaker.	Inconsistent use of voice to support message. Monotone passages interfere with audience interest. Rate may be too fast or slow; volume too high or low. Pitch is strained at times, too artificial or too nervous.	Fails to maintain audience interest and support the verbal message due to excessive monotone, inappropriate rate and volume. Pitch may be strained or flat.
Fluency: pronunciation, enunciation, articulation are smooth; lack of fillers	Coherence of presentation strongly supported by correct pronunciation, confident enunciation and articulation. Pauses are purposeful and enhance fluency of speech. Virtually no vocalized fillers are noticeable.	Careful pronunciation supports coherence of presentation. Enunciation and articulation of words are mostly clear. Pauses were momentary and did not interrupt fluency of speech. Vocalized fillers are minimal and do not distract the audience.	Pronunciation is mostly correct yet enunciation and articulation are still tentative. Speaker recovers from awkward pauses and proceeds. Vocalized fillers are noticeable but not excessive.	Coherence of presentation strongly supported by correct pronunciation, confident enunciation and articulation. Pauses are purposeful and enhance fluency of speech. Virtually no vocalized fillers are noticeable.

*Special thanks to Valencia Community College for developing this framework.