Shaping policy, sharing solutions, strengthening communities

Taking ANCOR’s Message to the Hill: How to Have Positive Meetings with Your Members of Congress and Their Staff (and Enjoy the Experience!) Licy DoCanto, The DoCanto Group Barbara Merrill, Vice President for Public Policy, ANCOR April 11, 2013

Topics to Be Covered Basics for Successful Meetings Medicaid Overview Current Threats Why it needs to be protected ANCOR’s National Advocacy Campaign Senate Proclamation Further resources

Many of us often feel that the Congressional legislative process is deeply intimidating, beyond our influence anyway, and that a visit to the dentist may be more enjoyable. So why bother?

Because Your Voice Matters! As a constituent, your voice is very important and powerful at all levels of government. The first job of an elected official is to get elected subsequently, they are very responsive to individuals who live in their district and have the ability to vote either for or against them.

The voice of a constituent, and even better, an organized group of constituents, is very powerful. In other words, they WANT to hear from you, and will treat you very respectfully…as long as you are respectful to them.

“Lobbying is not a one time activity. Successful lobbying is about building a relationship over time with an elected official and their staff. As with any relationship, mutual respect and trust provide the best foundation for educating, and ultimately convincing, someone of your position. This is important to remember as you move through what often can be a long term, and sometimes challenging, process.” From the Raben Group's “Art and Science of Lobbying”

The key to your success is to: Be prepared, respectful and ready to be into for the long term, and Be confident that the knowledge you have gained from your daily work makes you an expert whose perspective will be valuable to your elected officials.

The Nitty Gritty: Making the Appointment When attempting to meet with a member, contact the Appointment Secretary/Scheduler. You can call either their home district or their DC office, depending on where you want the visit to take place. Unable to come to our conference? The home district, as opposed to Washington, is usually better, as they frequently have more time for you, it's patently clear that you are constituents, and it's obviously easier to get to.

Making the Appointment If you don’t know who represents your organization and the individuals you support, use ANCOR’s Action Center to look up your members of Congress.ANCOR’s Action Center This online site is easy to use, and also provides contact information.

Making the Appointment – continued Explain that you are a constituent, and the name and location of your organization. Be ready to share all of the names of the people that will accompany you for the appointment. It is easier for congressional staff to arrange a meeting if they know what you wish to discuss and your relationship to the area or interests represented by the member. We recommend asking to meet with the staffer with responsibility for Medicaid.

Making the Appointment – continued Tell them that you are a member of ANCOR, and that you would like to discuss: Medicaid and (for Senate offices only) Co-sponsorship of the Senate Resolution recognizing the 2013 National Direct Support Professional Recognition Week Coming to our conference? Tell them that you coming to DC for the ANCOR’s Annual DSPs to DC conference

Prepare in Advance Typically, 3 to 5 people make a good number for a visit. ANCOR members from one state often team up. Choose a leader of the group who will facilitate the meeting. Decide, and rehearse, ahead of time who will say what in which order. Lobby visits rarely go exactly as planned, so be flexible. Planning ahead should ensure that all your major talking points are covered and that everyone has a role.

Prepare in Advance Have your organization's facts at your fingertips – preferably one page, with your branding. Include # of people served, # of employees, locations and types of programs. Do your homework. If you do not already know about your legislator, read up on him/her. Has he/she sponsored ANCOR legislation in the past? If unsure, contact ANCOR staff Look for connections - was she/he a Special Ed teacher? Have a family member with a disability? Go to your school?

Think “Hook, Line & Sinker” Hook: tell them who you are, where you are, what you do Line: Tell them why what you do is so important - why Medicaid funding for quality services/addressing the workforce crisis is so important Tell your personal story!

Think “Hook, Line & Sinker” Sinker: clearly communicate what you want the member to do - a simple message that you can deliver quickly if necessary. “That’s why we want you to protect Medicaid home and community based services for people with disabilities and oppose any legislation that would jeopardize this critical funding”

ANCOR’s message is to ask your members of Congress to: Protect Medicaid When meeting with Senators, to co- sponsor the 2013 Senate Resolution to Recognize National Direct Support Professionals Week Talking points later in slide deck, also will be posted on the web, and available at the conference

Going on Your Visit Be on time. Plan for delays in getting through security lines, and often long distances between offices. Dress appropriately, preferably business attire. Be sure everyone in your group is introduced. Always start on a positive note. Find something to thank the office for, some supportive statement or vote in the past. If nothing else, you can always thank them for taking the time to meet with you.

Expect to Meet with Staff In Congress, it is very common that you will meet with the member’s staff, not the member him/herself. Staff can exercise great influence on how the official will vote, so do not view meeting with staff as a waste of time. Or, if you view it that way (you will be wrong) do not show it. Often these folks call the shots, because they have superior knowledge about the issue, the Member trusts them, or both.

Conducting the Meeting Use the hook, line & sinker approach: present as you and your team planned. Do not assume the staff or official knows anything about our issues. Be concise. Most visits are relatively short. For members of Congress, plan on having no more than 15 to 20 minutes, and often you will have much less and, when meeting with a House member’s staff, don’t be surprised (or look disappointed) if the meeting takes place in the hallway.

Conducting the Meeting ‒ continued Ultimately, lobbying is about having a conversation. A key element to lobbying is to find out where the elected official is on the issue - that requires that you ask specific questions and wait for the official to answer them. Ask them where they would be on the issues you raised, and what concerns they might have. Try to get specific commitments. If the official does not want to commit on the spot, ask when you can follow up to get a definite answer.

Conducting the Meeting ‒ continued If you are asked a question you do not know the answer to, say you don’t know. DO NOT make something up, or even hedge. This opening actually provides an opportunity for follow-up. Remember that lobbying is about a relationship. You want the official and staff to trust you and see you as a credible resource. If you give incorrect information, you will severely undermine that credibility.

Conducting the Meeting ‒ continued Finally, end on a positive note. Even if you have not found anything you agree on, you can agree to keep talking. Never threaten to defeat the official in their next election. It will destroy your relationship with the official, and you can almost never deliver on that threat. Again, if nothing else, thank them for their time.

Follow-Up Following up is a critical part of relationship building and can help establish you as an expert on the issues discussed during your meeting After a meeting, be sure to send a thank-you note. For example, you could send an to the staff that you met, thanking them and repeating your ask. It is important to follow up on any questions that might have come up during the meeting.

Follow-Up Share feedback from your meeting with ANCOR Government Relations staff Barbara Merrill Katherine Berland Link to feedback form on ANCOR website

Medicaid Basics – What is Medicaid? The nation’s publicly financed health and long- term care coverage program for low-income people entitlement program like Social Security and Medicare covers parents and children in both working and jobless families, individuals with diverse physical and mental conditions and disabilities, and seniors. largest public health insurance program in the United

Medicaid Basics - How is it funded? The cost of Medicaid is shared by the federal government and the states. The federal share is called the Federal Medical Assistance Percentage (FMAP) and is based on a formula which takes into account the state’s poverty level. The minimum FMAP is 50%, but goes higher in poorer states. Overall, the federal government funds about 57% of overall Medicaid costs.

Threats to Medicaid funding In the current political climate where long- term debt/deficit reduction is at the forefront of conversation, Medicaid and the other entitlement programs are at risk of losing federal funding. Congress and the President are looking at ways to address the country’s long-term debt/deficit reduction strategy.

Threats to Medicaid funding Medicaid continues to be particularly vulnerable right now because most states cut Medicaid spending during the recent economic recession. States reduced services to beneficiaries, cut provider rates, and are not in a position to find further savings

Threats to Medicaid funding - Proposals Converting the program to a block grant system Implementing per-capita caps, which would provide states a set amount of funding per Medicaid enrollee Reducing the use of assessments fees which states use to fill in gaps in their Medicaid programs with federal dollars.

Talking Points - Medicaid Ask your Members of Congress to preserve Medicaid funding for home and community-based services and supports for people with disabilities, and to reject any actions that shift costs to states. People with significant disabilities rely on Medicaid-funded community supports and services to avoid expensive, segregated institutional placements.

Talking Points - Medicaid Medicaid funded community services are critical to enable people to live and work with dignity in their own communities, and our local economy needs the jobs that Medicaid directly supports. Medicaid dollars are an important part of every community’s economic engine, used to purchase goods and services, and provide jobs

Talking Points - Medicaid Community services limit institutional costs and help states moderate the growth of Medicaid spending. On average, four persons can receive home and community based services for the annual cost of one institutional placement. Unlike most of the other long-term care services, Medicaid provides virtually all of the funding for community based services - there is no private insurance.

ANCOR’s National Advocacy Campaign Advocates for the resources necessary to recruit, train and retain a healthy, sustainable direct support workforce. Our goal is to elevate: Wages Professionalization Recognition

ANCOR’s National Advocacy Campaign Wages and Jobs Advocacy to protect federal Medicaid funding Professionalization Working to provide career development opportunities for DSPscareer development opportunities Partnership with NADSP

ANCOR’s National Advocacy Campaign Recognition Raising public awareness about Direct Support Professionals (DSPs) and the important work they do. DSP Recognition Awards and DSP Recognition Week were created to honor outstanding DSPs and to spread awareness in communities across the country.

Direct Support Professional Recognition Week Initiated by ANCOR to honor outstanding DSPs, spread awareness in communities across the country and educate Congress ANCOR members and staff work to obtain a U.S. Senate Resolution and State Proclamations Senator Collins (R-ME) will sponsor We are seeking co-sponsors Scheduled for September 8 th, 2013

National Advocacy Campaign – Talking Points People with disabilities depend on DSPs for quality, consistent supports and services to live fully engaged lives in their communities Poor wages creates high turnover in this demanding profession DSPs are among the lowest paid workers and typically need another part time job to make ends meet. Many rely on public assistance and health benefits

National Advocacy Campaign – Talking Points Reported national average for DSPs working in private agencies is 9.85 an hour, compared to $15.48 per hour in state-operated facilities – a 57% disparity (2009 data) New study to be released late 2013/early 2014 Annual DSP turnover rates range close to 50% with constant vacancies High costs associated with constant recruitment, orientation and training

National Advocacy Campaign – Talking Points Need for DSPs is acute Supreme Court affirmed in Olmstead ruling that people with disabilities have the right to community living in the least most restrictive environment Family caregivers are aging, people with disabilities are living longer Number of DSPs needed to meet demand will grow to 1.2 million by 2020

Further resources available on the ANCOR website: Facts about Medicaid Advocacy Toolkit ANCOR’s Action Center ANCOR’s National Advocacy Campaign ANCOR 2009 Wage Study

Shaping policy Sharing solutions Strengthening Community Barbara Merrill, Vice President of Public Policy