1. Advocacy and Grassroots Making Your Voice Heard!
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2. Objectives
Define grassroots and advocacy
Advocacy tools
Special interest groups
AMCP’s tools to make your voice heard
Your role

3. What Is Advocacy?
Organizing individuals and coalitions to inform and hopefully influence legislators and regulators by providing research, data and information about a particular issue.
Essentially advocacy is informing and educating elected officials. Elected officials are not experts in every issue, and they depend on professionals to provide research and information about how things work in the real world.
The reality is that most elected officials are lawyers or businessmen. Most of them have bachelor’s or master’s degrees, but there’s no way they understand the ins and outs of every issue. And they are faced with making decisions on every issue under the sun.
For example:
What taxes are necessary and how will it effect the economy?
What government programs can we cut and have the least negative impact on society? Should it be transportation funding? Education funding? Medicaid funding?
How do we provide energy solutions that are efficient, cost-effective, and environmentally sound?
Which roads and bridges to we build this year?
How do we improve the quality of food served in schools?
I’m not kidding when I say every issue under the sun. And keep in mind that very few elected officials are medical professionals and even fewer are pharmacists. It is very important that we help them by providing information based on research and our experience as professionals.
And make no mistake -- they are very interested in hearing from us. They know they don’t know everything, and they are grateful for experts to step forward and provide relevant, current information so they can make an informed decision. They want to hear from you.
It’s true that they will hear from both sides of an issue – for and against – and that’s ok. In fact, that’s important to the political process. Which means, since the other side is speaking up, we also need to speak up and inform the legislator of our experience and our research on an issue. That’s what advocacy is.
Advocacy is not about fighting. It’s about informing.

4. Why do I care? Public Policy Impacts the Profession Drug standards
Safety standards
Professional scope of practice
Structure of health care delivery
You may be thinking how far removed government is from your daily life – you’ve got reading, exams, memorization, patient safety, chemistry class, a party you’re going to this weekend…
But seriously. Who do you think decides whether a drug can be sold in the U.S. or not? Who do you think categorizes the drug classes? Who determines whether pharmacists are allowed to administer vaccines?
All of these decisions are made by the government. Every health profession is highly regulated, and if health professionals aren’t in the conversation, the lawyers have a very good chance of screwing it up. We better be there when decisions are being made.

5. Tools Used in Advocacy Lobbyists PACs Research and Polling
Public Relations
Grassroots
Organizations have many methods of informing elected officials about their research and experience on an issue.
As you know, lobbyists are professional advocates for an issue. They are paid to know their issue forward and backward, all the research, and all the pros and cons of an issue. Then they’re responsible for explaining it to elected officials.
Most lobbyists work for an organization or a company to represent their issues to elected officials. Good lobbyists know that their reputation is their most valuable asset, and they will work to maintain good relations with all elected officials on both sides of the aisle. Their credibility, their honesty, and the trust that they gain over time are their most important assets. Yes, every profession has a bad apple. But good lobbyists know their boundaries and understand that success depends on trust, respect, and integrity – or they won’t last long.
PACs are Political Action Committees. These are committees that fundraise on behalf of a specific cause like heart disease or animal protection, etc. They are allowed to donate the money to political campaigns – and only campaigns – with the goal of supporting candidates that they hope will be elected to office. PACs are highly regulated and closely monitored by the federal government, and all donations are reported; so it’s a very “official” and safe way to contribute to a campaign. I’ll talk about PACs again on a later slide.
In addition, Organizations also use academic and think-tank research to explain their position on an issue, and they also use polls to gage public opinion on an issue.
Public relations is essential for getting out a message to the public and to elected officials, and all types of media are used to explain the message – social media, newspapers, t.v. commercials, etc. The goal is to share a message and give a positive impression about the organization.
Finally, and what we’ll spend most of our time discussing, is the grassroots – or the membership of an organization. Non-profit organizations, in particular, depend on their members to be the professional expert, who work in the community on the ground everyday, to be the local ambassador for the profession when interacting with the public and elected officials. Everything you say about your profession on social media, or when you explain your job to friends and family, influences how those people think about the profession.

6. Special Interest Groups – Evil or Us?
I want to talk about the term “special interest groups.” If you listen to the news media or TV commercials during election season, you’ve probably heard about special interest groups and how bad they are -- that they distort the political process and that elected officials should ignore them.
The media derides special interest groups and uses the phrase as if it’s a bad word. The truth is not so clear.
You have to remember that special interest groups are the same thing as associations. And associations are non-profits. Their primary goal is NOT to make money. Their primary goal is to serve the focus of their mission, whether it’s policy research, professional development, or a social cause.
One of the constructs of the American political system is that the voice of the minority is allowed to be heard through the masses. Associations allow small groups of people with a common interest to organize and be heard, whether it’s for health issues or the protection of animal rights. Associations are an important component of our political system.
AMCP is an association. We are a professional society for a small niche in the pharmacist profession – managed care – who would otherwise be lost in the noise of the other pharmacist associations.

7. Who are these Special Interest Groups?
More than 1.3 million associations in the U.S.*
American Heart Association
National Association of Realtors
American Dental Assn.
Motion Picture Assn. of America
American Concrete Pavement Assn.
Specialty Wiring Assn.
Energy Bar Assn.
There is a special interest group for almost every category of life you can think of.
Well-known organizations like the American Heart Association all the way to very narrow fields like specialty wiring and energy bar associations
Associations play an important role in our democracy:
Social organizations
Professional societies
Policy research organizations
Serve the public by:
Provide a forum for policy debate and research that the government doesn’t have time or resources to do
Represents a segment of the population so that their issues and expertise are heard in the public forum
Provides a means for people of common interest or profession to gather, share ideas, share best practices, stay current on changes and trends in the industry, and improve their professional skills.
Without associations:
People with common interests and concerns would have difficulty being heard as a group in Congress or state legislatures
Professionals would have difficulty seeking continuing education and staying current in their field.
Health issues and consumer safety issues would not be well heard in Congress or in state legislatures
*American Society of Association Executives, March 29, 2012

8. And Pharmacy Groups? American Assn. of Colleges of Pharmacy
American Assn. of Pharmaceutical Scientists
American Pharmaceutical Association
American Society of Consultant Pharmacists
American Society of Health System Pharmacists
Board of Pharmaceutical Specialties
National Association of Boards of Pharmacy
National Association of Chain Drug Stores
National Community Pharmacists Association
There are lots of groups representing the interests of the pharmacy profession, as you know. You may be members of some of these organizations.
These groups work together on some issues and disagree on others. However, these groups talk to each other a lot, which allows debates to happen together as an industry before it gets to Congress or the state legislature or the courts.
Every profession has a similar list of organizations that impact their work and allow discussion, dialog, research, and debate within the profession to develop best practices, resolve differences, and encourage cooperation without the involvement of government.
These interest groups actually save money for the government. They also help keep the government out of a lot of research, best practices, and procedures and standards decisions.

9. Advocacy Activity
Number of Organizations Advocating on Health Issues in Congress, *
All of these non-profits have government affairs departments who advocate on behalf of their members’ interests – whether it’s their profession or a social issue – the government relations department works to make sure elected officials understand their point of view and research on an issue.
As you can see, advocacy activity – or meetings -- on Capitol Hill was prevalent during the healthcare reform debate in the 2000’s leading up to when the bill was signed in March This just shows how much work goes into educating elected officials about the issues and providing them research and expertise about the application of public policy and how it will effect society once it’s law.
* accessed March 29, 2012

10. Top PAC Spending for 2013-14* National Assn. of Realtors $3,804,455
National Beer Wholesalers Assn. $3,017,000
National Auto Dealers Assn. $2,795,350
Honeywell International $2,705,373
Lockheed Martin $2,632,750
American Bankers Assn. $2,533,875
AT&T, Inc $2,504,250
Int’l Brotherhood of Electrical Workers $2,467,214
Credit Union Nat’l Assn. $2,381,500
Operating Engineers Union $2,361,742
And most of these non-profits have a Political Action Committee. As you can see, non-profits are the majority of the top-10 donations to campaigns. There are only three corporations on this list.
It’s interesting to see how much the big PACs donate to campaigns in an election year.
Most PACs do not wield this kind of influence, but PACs are a great way to pool small donations by individuals so that together they can have a greater impact on which candidates are elected to office. Your $10 donation will go a lot further if you donate to a PAC than if you donate directly to the candidate.
So, for example, if we look at the biggest donor on the list – NAR – if all the realtors in the nation donate to the National Assn. of Realtors PAC, those donors know that their contributions are being donated to candidates that support the issues important to realtors. This is one way for organizations to work together for a common cause in the political system.
Most large organizations have a PAC, so if you agree with the values of the organization, it’s worth it to donate to that PAC. AMCP does not have a PAC, but lots of other pharmacy organizations do, so you will hear about PACs a lot during your professional career.
accessed January 30, 2015

11. Research and Polling
Advocacy Polling – assists organizations in marshalling the power of public opinion to achieve their objectives.
Advocacy Research – assists organizations in providing academic support for certain positions
Another tool organizations use to have influence at a national level and to change public policy is to win the hearts and minds of a broad swath of the population. If you can do a pubic opinion poll and show that a majority of the population feels a certain way, those statistics can be influential to policy makers, if used in combination with your other advocacy efforts.
In addition, policy issue research is effective for providing information on the hows and whys of our positions. In other words, how would the policy impact society at a practical level? Have their been pilot programs, and what has been the results?
Think tanks such as the Brookings Institute and the Heritage Foundation solely focus on research and academic studies of public policy and their implications on our country and/or the world. Some professional associations have their own departments that focus on policy research. This research is used to inform elected officials on the impact of public policy, and why a policy works or doesn’t work.

12. Public Relations
Paid Media – Effectively delivers your message when you want it – with a pre-determined level of intensity Earned Media – Greater credibility since it’s delivered and received through the filter of a credible third-party organization such as a newspaper, TV or radio station
Public Relations are an important component of effective advocacy because PR helps shape the impression the public has about your organization, whether it has a reputation as a respectable and trustworthy organization, and also whether the organization’s positions on policy issues are being heard. Media is typically categorized into two parts – paid and earned.
Paid media are advertisements you run in publications or online, TV, and radio. These are advertisements the organization has paid for in order to deliver a specific message.
Earned media is when some other organization references your organization’s work in the media, such as in a printed article or research journal, or during a TV interview, or links to you on social media, etc. This is valuable because you’re not tooting your own horn. This is someone else saying you’re a credible and respectable organization, and your work or opinion on a policy should be acknowledged or recognized in some way.
Organizations have professional staff that manage public relations and communications in order to ensure consistency and accuracy of the message presented in the media.
Interactive Question for the Audience:
Before I click on the next slide, if you remember at the beginning I referenced grassroots as an important part of the advocacy process. Can anyone help me define what the “grassroots” is and what they do?

13. Grassroots
Effective organizations mobilize their members, employees and coalition partners to advocate for or against an issue.
Called grassroots because grass spreads throughout the community, and the country, and has broad coverage. The grassroots is the general membership – you and me. We’re on the ground, living and working in our communities, interacting with patients, our colleagues, family and friends, and we’re working to provide more quality healthcare nationwide. We have broader reach across the country than the staff of AMCP has in Washington, D.C.
AMCP Committees and leaders are called the “grass tops” of the membership. The grass tops are the organizers and coordinators of the general membership.
The grassroots are the people who know what’s going on at a practical level, they experience day to day activities as pharmacists, and can build relationships at the ground level.

14. AMCP and Grassroots Advocacy
Advocacy is a central tenant
Leadership Structure
Legislative and Regulatory Action Committee (LRAC)
Public Policy Committee
State Advocacy Coordinators
Government Relations Staff
Within AMCP:
We have a structure to encourage AMCP members to get involved with advocacy through our grassroots network.
At the top are two committees: LRAC and the Public Policy Committee.
LRAC members watch state legislation around the country and help AMCP staff stay informed of where the bills are in the legislative process. This helps AMCP staff decide what actions to take and how best to get involved in the legislative debate happening in the states.
The Public Policy Committee drafts AMCP’s position on the policy issues important to the profession. The draft is then sent to the AMCP Board of Directors for its review. Once the Board approves a position, AMCP can advocate on that position and engage in the political debate.
The State Advocacy Coordinators are volunteers who act as a key contact for issues in their state. More on this in a moment.
Government Relations staff leads the whole effort and coordinates the work so AMCP has a cohesive strategy and plan for advocacy across the country.

15. Regional opportunities for AMCP members
AMCP Affiliates
Regional opportunities for AMCP members
State Affiliates are regional groups sponsored by AMCP that offer a chance for networking and peer-to-peer collaboration within the profession. There is not an affiliate in every state or region.
State affiliates: Georgia, Texas, Utah
Regional affiliates: Midwest, Northeast, Ohio-Kentucky
Regional affiliates have their own events and opportunities for networking. Many track state legislative issues.
(Talk about your own experience if you live in a state with an affiliate.)

16. State Advocacy Coordinators AMCP State Leaders - 1 or 2 per State
Mobilize Member Involvement
Legislative & Regulatory monitoring
Work with Stakeholders
Communicate with AMCP Members
Coordinate with AMCP staff
S.A.C.s monitor state issues and mobilize volunteers – the grassroots – when necessary. They’re your contact for public policy in your state and in congress.
Contact your S.A.C. if you have questions about a public policy issue AMCP is working on or legislation in your state.
Also, let your S.A.C. know if you’re interested in being involved so they can contact you when we need to take action together.
If there is not an S.A.C. yet in your state, contact AMCP government affairs staff if you have any questions about public policy issues.

17. AMCP Tools for Advocacy
State bill tracker
Policy Issue toolkits
Legislative/Regulatory Briefing (monthly )
State Advocacy Coordinators
AMCP Government Affairs Staff
(Read this list. Future slides explain these in more detail.)

18. Legislative Tracking http://www.amcp.org/statelegislativetracking/
All the Bills AMCP is Tracking
Priority bills
Bills to monitor
Full bill text and current status
Take the guesswork
out of bill tracking!
First, let’s look at tracking state legislation.
AMCP staff and the State Advocacy Coordinators monitor and track thousands of bills in all 50 states. When a bill comes up that impacts managed care pharmacy, we can strategically decide how and when AMCP should become involved in the debate.
You can also see the bills we watch. Everything AMCP tracks is available at our state legislative tracker, which shows the status of legislation in real time. It also gives you the full text of the bills.
Click on the interactive map to see the bills in your state or any other state.

19. Research and background on major public policy issues
Policy Issue Toolkits
Research and background on
major public policy issues
Topics Include:
Carve-out exemptions
Specialty Tiers
Oral Chemo Parity
Pharmacy Audits
Uniform Prior Authorization
Mandated Coverage
Others
Medicaid Managed Care
The policy issue toolkits are a single webpage that provides a comprehensive view of a policy issue. It has a policy description, sample legislation, research on the issue, and the position that groups have taken on the issue, including AMCP’s position.
If you don’t know anything about a topic, this is a great place to start. There are more topics than we were able to list here, so check the website.

20. Action Alerts
Best way to contact your elected officials when there’s an important issue
AMCP sends you an
Click “take action”
Fill out name and zip code
Click Send
Your voice is heard!
Action Alerts are s asking you to one of your elected officials about a particular bill. These are extremely important when we need to explain AMCP’s position on an issue in a hurry. It’s usually right before a vote and is often a last-ditch effort to ask a legislator to vote a certain way.
AMCP doesn’t send these very often because they’re only valuable if they’re sent at a strategic point in the political process.
Action Alerts:
Guarantee AMCP members all deliver the same message as one voice representing AMCP and managed care pharmacy as a profession.
Guarantee your message is delivered to the right legislator (yours!) and that it doesn’t get caught in a spam filter.
Easiest way to contact your elected official – you don’t have to write the yourself. AMCP writes it for you.
You must respond within 48 hours in order to have an impact. It’s all in the timing, and that’s essential. You have to respond right away when you see one of these s. As you can see here, it’s a very easy four step process.

21. Useful How-To Guide for
Action Alerts
Useful How-To Guide for
AMCP Action Alerts:
Click Here to Your Elected Official
If you want more information about Action Alerts, what they do, and how they work, you can check out this brief power point for more information.

22. Newsletter Legislative & Regulatory Briefing Electronic All member
Monthly
The Academy sends a monthly government affairs newsletter to keep you up-to-date on what happened over the past month in Congress and in the states. It talks about the issues that were hot, the comments they submitted to the regulatory agencies, the briefings they attended on Capitol Hill, and actions taken by S.A.C.s in the states. AMCP members get this automatically. You don’t need to sign up to receive this.

23. Why Should I get Involved?
You’ve seen the stats – PACs, professional lobbying, Advocacy Groups… someone is telling your story – but not necessarily the way you want it told.
Managed Care Pharmacy is a very narrow niche in the pharmacy profession, and most elected officials have no idea what you do, and probably haven’t ever heard of managed care pharmacy at all.
As professionals, we have to makes sure we explain what we do and how we contribute to the health care system. It’s essential to work with our elected officials so we can take part in the decisions that are made.
(This is a good place to tell your own story. Give a personal example or tell about your experiences meeting with elected officials and why it’s important to you as a professional and/or a citizen.)

24. Why Should I Get Involved?
State Legislatures 6x more productive than Congress
States:
45,564
Bills & Resolutions
Congress:
352
Bills & Resolutions
And it’s particularly important to pay attention to what your state legislature is doing. As you can see here, the state legislatures are much more active than Congress in Washington, D.C. The numbers shown here are bills passed by these legislative bodies between , so this is 2 years worth of legislative activity, and you can see that Congress moves much more slowly.
It’s interesting to note that these are just the bills that were approved by both chambers. The reality is that hundreds of thousands of bills were introduced, and these are just the ones that made it to the executives’ desks.
In Congress, these 352 bills and resolutions are only 4% of the bills that were introduced. Between all 50 states, an average of 25% of the bills introduced were passed by both chambers. So there is a lot of activity happening, and a lot of policy issues to keep track of and help legislators understand before they vote on them.
You should keep in mind that the states are often called the laboratories of America because they will frequently implement a policy that’s new and innovative, and then they’ll see how well it works. Other states, and even the federal government, can learn from their experience and implement a similar policy with improvements, or decide it didn’t work and avoid that policy all together.
Because state legislatures are on a smaller scale than Congress, it’s generally easier for them to pass legislation. However, sometimes it’s easier because the public doesn’t pay as much attention to their state legislature – which means – and this is important – because the public isn’t paying attention, the state legislatures can sometimes pass legislation that is extreme or incredibly controversial without getting much opposition.
This is why you need to pay attention to your state legislature.
State associations, like our state pharmacy association, pay attention to state legislation that impacts the profession, and they are able to focus on one state – our state. In contrast, national organizations, like AMCP, do their best to track all the state legislatures, but it’s much harder to track 50 states than it is to track 1 state.
The other reason it’s easier to track Congress is because Congress moves slower than state legislatures. There’s generally more deliberation and debate because there are a lot of advocacy groups, constituents, and the media, paying attention to what Congress is doing at the national level. In the states, it’s usually just the state newspapers and the state associations that pay attention. State legislative activities rarely get national attention.
Therefore, AMCP needs all the help we can provide at the state level. If you see something that relates to a bill AMCP is tracking, you should contact your State Advocacy Coordinator and see if that information can help. You can also join your state pharmacy association and support their effort in tracking state legislation.
SOURCE:
State Legislatures and Congress: session number of bills & resolutions that passed both chambers
Source: Accessed 1/29/15.

25. Social Media Follow your elected officials State and federal
Sign up for their newsletter on their website
Watch their speeches on YouTube
So, what else can you do?
Get to know your own elected officials for your own state legislative district and your own Congressional District.
Don’t just assume your elected officials are corrupt, no-good people. Learn about them and the work they’re doing. Most elected officials run for office because they want to have a positive impact on society. They are not paid enough to be there for selfish reasons. Yes, there’s a bad apple in every line of work, but don’t make assumptions just because they’re elected into office.
The more you know about your elected officials, the more effective you will be when you have the opportunity to meet them. And there will be an opportunity. You are the experts on managed care pharmacy, and they will need your help understanding the healthcare system and how best to provide care for people.
Don’t assume they know or understand what managed care does. Managed care pharmacy is a narrow niche in the pharmacy profession, and they are interested in your help and insight.

26. Register to vote Don’t skip election day Be heard & Participate
2016 is a big election year. Besides the Presidential election, the entire U.S. House of Representatives is up for election, because they are elected every two years. In addition, one third of the U.S. Senate is up for election.
And then there are state elections. Many states have governors who are up for election, as well as state-wide offices like the State Treasurer and the Secretary of State. Plus, both houses of our state legislature is up for election. In addition, your local county and city officials are running for office.
Don’t take it for granted. Make sure you read about the candidates and vote on election day. The AMCP Advocacy Center will show you who the candidates are for all the offices in your region – in your town, in your state, and in Congress.

27. Voters have Influence 37,247,000 voted (69.1%) Senior Citizens
51,859,000 citizens aged 55-74
37,247,000 voted (69.1%)
Young adults
60,009,000 citizens aged 18-34
32,016,000 voted (46.4%)
The most amazing fact about the United States is that the youth do not vote as much as the senior citizens. And what’s crazy about this is that there are more of you than there are senior citizens!
But if you look at the green triangle here, more senior citizens vote. So guess who the elected officials pay attention to? You really DO have to show up on election day in order to have an impact. Don’t take it for granted.
The numbers here are from 2008, which was Barack Obama’s first presidential election against Senator John McCain. If you remember, that was a year when young people were very involved and very excited about the election.
So this represents the year when lots of young people voted, and you still didn’t beat the senior citizens. So just think what happens on the other years. You really do have to vote every year.
Source: U.S. Census Bureau; Reported Voting and Registration of the Total Voting-Age Population, by Age, for States: November 2008  

28. Organize a legislative policy seminar
Campus Events
Organize a legislative policy seminar
or a day of events
Two or three 60 minute panel sessions on specific public policy topics
A speaker on how to be effective in the political process
Register to vote sign-up table
AMCP staff can help discuss panel topics and event organization ideas
Contact Sarah Vizcaino and Dana Whitley
If you want to organize a campus event, here are some ideas and some things to keep in mind.
First, your goal should be to educate and inform the students about how advocacy works, and the role of associations and the grassroots. A lot of what I discussed here today is important for the students on your campus to understand. Help them be comfortable with the political process, and then also discuss public policy issues important to the profession.
I didn’t get into public policy positions today, but AMCP has all that information on their website, so you can read about the public policy issues there and work with staff to decide which issues are most timely and which guest speakers to invite to discuss these topics.
It’s not necessary to organize a trip to your state capitol; and sometimes it’s not appropriate. Remember that timing is everything in the political process, and it’s important to consult with AMCP staff before you plan a group trip to see your elected officials to discuss AMCP policy issues. If your legislature is not working on an issue or they voted on the issue two weeks ago, it’s not a valuable use of your time or theirs to meet with them. Those types of events need to be strategically planned with AMCP staff to be the most effective.
In fact, if you do want to meet with our state legislators, I encourage you to participate in our state pharmacy association’s Legislative Day when they go visit the state capital. It’s very well organized, and you will have a great experience.
If you do a campus event, I would encourage you to focus on educating and informing the students about the political process and the value of being involved. Speakers and panelists in your community are usually very happy to speak about the political process. You could even collaborate with your campus political science department or economics department to organize an “advocacy information day” or “public policy information day.”
Sarah Viszcaino (say: vis-KAY-no) and Dana Whitley are very happy to help you plan an event if you contact them.

29. Washington, D.C. If you’re in Washington, D.C., let AMCP know.
Minimum two week notice
Individuals or groups up to 5
AMCP Staff will
Arrange appointments with Capitol Hill staff
Prepare you with what to discuss
Accompany you to the meetings
Contact: Mary Jo Carden
If you happen to be in Washington, D.C., for a conference or an event, AMCP can arrange for you to meet with the staff of your U.S. Representative or your U.S. Senators. Just let them know. AMCP staff will work with you in advance to prepare what to say and what to expect. The staff will also go with you to the meetings. This is a great opportunity to see Congress in action, first hand.

30. Can You Make a Difference?
And your involvement makes a difference. It may be cliché, but really, we can. If we work together as an organization and share our common message to the elected officials across the country, AMCP members can be heard. Public policy takes time, and changing the hearts and minds of people takes time, trust, and relationship building. Patience and persistence are very important in politics.

31. QUESTIONS