Mitchell Katz of the Los Angeles County Health Agency discusses how local health departments can experiment with new ideas in the spheres of public health and health policy, leading to wider adoption of programs and reforms. He cites several examples of success, such as the San Francisco Needle Exchange program of 1992 and strategies for treating patients with partners who have sexually transmitted diseases. According to Katz, these innovators often had to use creative means to work around existing laws. Katz notes that in his experience, research evidence is necessary but not sufficient for a lone actor to bring about policy change. It is critical to get the support of the medical establishment, and then bring that influence to bear on the political process.

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