ADVOCACY SKILLS TRAINING St. Paul, MN July 22nd, 2015

About the Consumer Voice The National Consumer Voice for Quality Long-Term Care was formed as NCCNHR (National Citizens’ Coalition for Nursing Home Reform) in 1975 because of public concern about substandard care in nursing homes. The Consumer Voice is the outgrowth of work first achieved by advocates working for Ralph Nader and later for the National Gray Panthers. Elma Holder, NCCNHR founder, was working with The Long-Term Care Action Project of the Gray Panthers when she organized a group meeting of advocates from across the country to attend a nursing home industry conference in Washington, DC. At that meeting, representatives of 12 citizen action groups spoke collectively to the industry about the need for serious reform in nursing home conditions. The consumer attendees were inspired to develop a platform of common concerns and motivated to form a new organization to represent the consumer voice at the national level. Most of the original members had witnessed and endured personal experiences with substandard nursing home conditions.

Goals To know how to: Craft an effective advocacy message Deliver the message in person Deliver the message through traditional and social media Grow, activate and support your organizational and/or personal networks

Heart Goals To feel: Supported – by all of us at Consumer Voice Connected – to Consumer Voice and each other Energized – to go back home, apply your advocacy skills, and advocate for 24-hour RN coverage!

Overview of the Issue Current law and regulations: Nursing homes receiving Medicare and/or Medicaid funding are required to have a registered nurse 8 hours a day, 7 days a week Registered nurse can be handling administrative duties

Why is this a problem? #1: Increased acuity level, medical intensity and complexity of residents #2 Residents’ condition can change at any time; only RNs can do assessment #3: Lower RN staffing levels associated with negative care outcomes

Put a Registered Nurse in the Nursing Home Act H.R. 952 Congresswoman Jan Schakowsky Would require all nursing homes receiving Medicare and/or Medicaid funding to have at least one registered nurse 24 hours a day, 7 days a week. Duties: Direct care Assessment Surveillance

What in the World is a Strategy Chart?

Strategy Chart ISSUE GOALS ORGANIZATIONAL CONSIDERATIONS CONSTITUENTS & ALLIES DECISION MAKERS & OPPONENTS TACTICS Vision Now Constituents Primary Decision Demand Then Allies Secondary Decision makers Fallback Opponents

Strategy Charts: What are they? Consumer Voice Strategy Chart for 24 Hr RN Coverage in Nursing Homes

Strategy Charts: What are they? ISSUE GOALS ORGANIZATIONAL CONSIDERATIONS CONSTITUENTS & ALLIES DECISION MAKERS & OPPONENTS TACTICS  Vision: Adequate staffing for nursing home residents   Demand: Mandate Medicaid and/or Medicare certified nursing homes to provide RN staffing 24 hours a day/7 days a week Pass HR 952, The Put a Registered Nurse in the Nursing Home Act Fallback: Mandate Medicaid and/or Medicare certified nursing homes to provide RN staffing 24 hours a day/7 days a week with waivers permitting facilities to not have 24 hour RN coverage 7 days a week under certain limited circumstances Now: -4614 dedicated individuals in CV Action Network -20 national organizations that indicated support in last Congressional session -114 state ombudsman programs, local ombudsman programs, citizen advocacy groups and family councils that indicated support in last Congressional session -Social media ability -Skilled in using online advocacy tool (SALSA) -Engaged and committed staff, Leadership Council and Governing Board -$207,000 for 2013-2015 staffing campaign Then (End of 114th Congress): -5,000 Action Network individuals -25 national allies supporting the bill -150 state ombudsman programs, local ombudsman programs, citizen advocacy groups, and resident and family councils supporting the bill -25 retweets about the bill -$10,000 funding raised to continue the campaign Constituents: Long-term care consumers, family members, citizen advocacy groups, individual citizen advocates, long-term care ombudsmen, resident councils, family councils Allies: National Association of State Long-Term Care Ombudsman Programs (NASOP); National Association of Local Long-Term Care Ombudsman (NALLTCO); Service Employees International Union (SEIU); PHI, Older Women’s League (OWL); Alliance of Retired Americans (ARA); Coalition of Geriatric Nursing Organizations (CGNO); Public Citizen; Community Catalyst; National Committee to Preserve Social Security and Medicare *to be reconfirmed Primary Decisionmakers Now: -Members of the U.S. House Energy and Commerce and Ways and Means Committees - All Members of the U.S. House of Representatives   (Later: All Members of the U.S. Senate; Members of the U.S. Senate Finance Committee; President) Secondary: Now - Staff Members of U.S. House Energy and Commerce and Ways and Means Committees -Staff of U.S. House of Representatives Members (Later: -Staff Members of U.S. Senate Finance Committee -Staff of U.S. Senate Members) Opponents: -Leading Age -American Health Care Association -American College of Nursing Home Administrators -In person trainings -Action alert to CV Action Network (When bill was re-introduced in February 2015) -National Webinar on issue (May 12) -Contact your legislator day (May 20) -District visits (Legislative District Work Periods: June 29th – July 3rd; August 3rd – September 4th; September 22nd – 25th) - Action Alert to Individuals with Members Serving on House Energy and Commerce and Ways and Means Committees (Summer 2015) -Hill visits on lobby day with American Nurses Association (July 22, 2015) -Hill visits by CV staff (throughout the 114th Congress) -Hill visits during annual meeting by participants (November 2015) Advocacy Planning Chart (based upon Midwest Academy Strategy Chart)

How to craft an effective advocacy message

THE BIG SIX Have an opening statement that includes your ask Present the problem Give the facts Give a personal example or story Connect to something your audience cares about Reiterate the “Ask”

Identify the Receiver This is the primary/secondary decision maker in your Strategy Chart.

#1. Have an Opening Statement Grab their attention! Open with a statement that engages your audience. Include your “ask” – tell them what action you want them to take.

#2. Present the Problem Lay out the issues: Why is this a problem? Who is affected?

#3. Give the Facts Facts. Figures. Data. Provide solid evidence to support your argument. Provide data relevant to your audience. When using statistics, provide a mental picture.

#4. Provide a Personal Example/Story Make it personal: Put a face to the issue Share observations Share personal experiences Tell a story

#5. Connect to Something Your Audience Cares About Do your research: Values Interests Concerns Voting history Self-interests

#6. Make the Ask Reiterate what you want the audience to do. Paramount Pictures

Be Prepared for Questions & Pushback Try to imagine every perspective …and every angle

Closing Closing your conversation is just as important as your opening.

Questions

DELIVERING YOUR MESSAGE IN PERSON: THE NUTS AND BOLTS OF MEETING WITH A KEY DECISION MAKER

Three Parts to Delivery Arrange and prepare for the meeting Conduct the meeting Follow up

Arranging & Preparing Determine the appropriate person to meet with.

Finding Minnesota Legislators Members of Congress www.opencongress.org www.house.gov or www.senate.gov Congressional switchboard 202-224-3121 Members of State legislature www.openstates.org Members of Congress & State legislators www.votesmart.org

Minnesota Legislature / U.S. Congressional Leaders New 114th Congress Began in January Senators: Senator Amy Klobuchar (D), Senator Al Franken (D) House Members: Tim Walz (D – 1st District); John Kline (R – 2nd District); Erik Paulsen (R- 3rd district); Betty McCollum (D- 4th District); Keith Ellison (D- 5th District); Tom Emmer (R – 6th District); Collin Peterson (D – 7th District); Rick Nolan (D – 8th District) State Legislature: Meets between January – May each year; Bicameral - 201 members (67 senators, 134 representatives)

Keep in Mind Secondary decision maker as back-up

Arranging & Preparing: Meeting Scheduled On the Fly Better chance of undivided attention Respectful of their time More weight Might be your only opportunity Be flexible Make an impression

Arranging & Preparing: Contacting State senator Call or email legislative assistant Congress Contact legislative staffer or scheduler Administrator Call directly

Arranging & Preparing: Tips Include information with your meeting request. If you don’t hear back, follow-up! Be on time. Prepare to meet anywhere – be adaptable!

Arranging & Preparing: Who Will Join Consumers Ombudsmen Family members Family council Resident council

Arranging & Preparing

Reviewing Your Message: Tips Don’t expect more than 30 minutes. Be prepared to shorten to 5 minutes. Assign speaking roles – create an agenda.

Leave Behind Kit Factsheet/Issue brief Pertinent data Folder Business card

Part II

Conducting the Meeting: Intro

Conducting the Meeting Thank your audience and make an opening statement. Start with something positive. Indicate the issue. Make the ask.

Conducting the Meeting Follow your agenda and

When Caught Off Guard If you’re asked a question and you don’t know the answer – Follow up If you forget to mention a key point – Follow up If you run out of time –

Conducting the Meeting: Tips Keep your cool. Don’t get overheated. Remain focused and calm throughout the meeting.

The Ask Don’t forget to make your “ask”. Listen for a “yes”. Clarify.

The Wrap-up Ask how you should follow up. Leave materials and contact information. Thank them again for their time.

After the Meeting Write a thank you note Key points Commitments Follow up

Follow Up: Again Periodically following up keeps you and your issue fresh in your audience’s mind.

Questions

Delivering your message: utilizing both traditional approaches and social media

Traditional Approaches

Phone Two kinds of calls: Short, just to communicate “the ask” Longer, substantive: Include Big Six

Mail & Email Remember the Big Six

Letter to the Editor: Reasons Why Strategy for action Influence public Educate public Influence officials thenorthstarnews.com

Letter to the Editor Tips: Grab reader’s attention. Important points first. Give suggestions. 300 words or less. Follow publication guidelines. Connect the issue. Statistics/Stories. Identify yourself.

Action Alert A message that an organization/group sends to mobilize people to take action to influence public policy.

Writing an Action Alert Inform based on where campaign is One page or less Readable (12 pt font +); Avoid jargon Important information upfront. Provide a date. Give the tools needed.

Action Alert Example

Sending an Action Alert Who should you send the alert to? People on your email lists or in your database Your own friends and family

What to do with an Alert: Go to Action Page

Action Page

What to do with an Alert: Send message

Personalizing Alert Messages Makes the message more meaningful, gets more attention To personalize: at a minimum: Identify yourself Add a personal story, observation, experience Samples Your turn!

Facebook You’re the reporter and the publication!

Facebook Advocacy Examples

Facebook Advocacy Posts H.R. 952, the Put a Registered Nurse in the Nursing Home Act, is a bill that requires nursing facilities and skilled nursing facilities (“nursing homes”) that receive money from Medicare and/or Medicaid to have a direct-care registered nurse (RN) on duty 24 hours per day, 7 days per week. Current law only requires facilities use an RN for 8 continuous hours each day, regardless of facility size. This current practice does not ensure quality care for our loved ones and must be changed. Click here to ask your Representative to co-sponsor this bill!

Twitter Microblogs of 140 characters or less called “tweets” - Use bit.ly to shorten a URL - URL’s are shortened to 22 characters

Twitter Advocacy Examples Ask Your Representative to Co-Sponsor H.R. 952, the Put a Registered Nurse in the Nursing Home Act http://ow.ly/AD5CG Round-the-clock RN coverage is critical in NHs. Ask your Representative to co-sponsor H.R. 952 today! http://ow.ly/AD5CG Nursing homes need more nurses. Support having a registered nurse (RN) on duty 24 hours a day/7 days a week! Click here to learn more http://ow.ly/AD5CG

TWEET STORM

How to use your advocacy to grow, activate and support your network

Organization/Program Assess Your Network Organization/Program Personal Who makes up your organization, program or coalition Who are your constituents? Who you have contact with: family, friends, neighbors, people in your faith community, etc.

Decide which constituents you want to “grow” Residents? Family members? Members of the community? Set a goal

Don’t Forget Your Allies Groups that are not necessarily going to become part of your network, but who would support the same issue.

Growing Your Network

Social Media Use Facebook and Twitter.

Speaking Engagements Ask to speak about your issue at meetings, conferences, and even local book clubs.

Outreach to Partner Organizations Send your informational notices about webinars, speaking engagements, and action alerts to partner organizations. Ask them to share it with their network.

Tactics That Can Help You Grow Postcards Action Alerts Petitions Town Hall Meetings

Postcards Postcard of information about the issue and a message to legislators or a statement of support.

Action Alerts Encourage everyone receiving an alert to forward it to other groups and individuals as a way to gain new advocates.

Petitions A hard copy petition: Captures names of new advocates. Allows those who don’t have computers or access to the internet a way to take action. Can be circulated at meetings.

Activating Your Network

Tactics Are Not Enough Getting people to engage is not always easy!

Make it easy for people to take action Create a toolkit

Staffing Campaign Toolkit http://theconsumervoice.org/betterstaffing#Toolkit

Give an Incentive Set a goal! Hold a contest with a drawing for a prize!

Essential: Follow Up & Thank You Follow up with your network and let them know what became of the action. Thank your network: individual notes, general post to website/social media, and newsletter.

Why Feedback Matters People need to know that their action made a difference – even if you were not successful.

Maintain & Support Your Network

What are some ways you can think of to support your network?

A.R.T. Action Have one action that all advocates hear about but perhaps not all can/will participate in.

A.R.T. Recognition Write one profile of an advocate in an e-newsletter.

A.R.T. Training Webinar/education, updates, engaging in updating strategy chart.

Seeking Your Advocacy Mate

And in closing….

Your Go-To People: Amanda Celentano acelentano@theconsumervoice.org 202-332-2275, ext. 221 Robyn Grant rgrant@theconsumervoice.org 202-332-2275, ext. 205 Marybeth Williams mwilliams@theconsumervoice.org 202-332-2275, ext. 225

Contact Us Consumer Voice 1001 Connecticut Ave., NW Suite 425 Washington, DC 20036 Ph. 202-332-2275 http://www.theconsumervoice.org Email: info@theconsumervoice.org