1. Geiger Gibson Capstone in Community Health Policy & Leadership Webinar Series 1.Executive Branch Role 2.Legislative Branch Role 3.Judicial Branch Role 4.Advocacy Role Merle Cunningham MD MPH - Program Director Geiger Gibson Program in Partnership with NACHC GWU School Public Health & Health Services

2. The Role of Advocacy in Health Policy April 14, 2015 Presented by Amanda Pears Kelly National Advocacy Director National Association of Community Health Centers

3. Learning Objectives At the end of this session, participants will be better able to: 1.Understand why & how advocacy influences health policy 2.Appreciate the keys to successful advocacy 3.Apply the rules for organizing grassroots advocacy 4.Understand the strategy behind the Access is the Answer Advocacy Campaign

4. Advocacy and Health Policy Good Policy Should Come First: Who Wants to Advocate for Bad Policy?

5. Why Does Advocacy Matter in Health Policy? Policy Decisions Do Not Happen in a Vacuum - Competing Priorities - Dueling Numbers - Health policy is about people Advocacy is Not Just Lobbying - Getting Policymakers to Pay Attention - Getting Legislators to Vote Yes (or No) Legislative Decisions ALWAYS Involve Politics - Good Policy Development is not enough - Sometimes votes matter more than relationships - What Good is Perfect Policy that Never Becomes Law?

6. Action = Effective Advocacy Effective advocacy has one requirement: ACTION –Simply discussing issues, challenges, and plans is NOT effective advocacy. To Be An Effective Advocate & Attain Your Goals You MUST –Make advocacy an ongoing commitment and priority. –Translate discussions, plans, and passions into moveable actions. –Make your voice and perspective heard and understood.

7. Effective Advocacy = Power Grassroots advocacy is about BUILDING POWER –Power is not measured by the number of advocates on a list –Power is not measured by the number of small (or even large) victories we win. Power must be measured by our ability to successfully advance our own agenda and to make it unthinkable that any other political or special interest would ever want to take us on.

8. The Real Deal: Relative Effectiveness of Advocacy Communications 1. A visit to your health center 2. A personal meeting back home 3. A personal meeting in Washington 4. Personal telephone calls 5. Personalized Letters (faxed) 6. Personalized emails 7. Template emails (ineffective unless in volume)

9. Advocacy 101 The Basics Know what you want Know who can give it to you Know what they want Know how to make the loudest squeak Advocacy is an ongoing effort Keys to Successful Advocacy Advocacy is a competitive activity There are winners and losers and, sometimes a stalemate is a win! Advocacy is an ACTIVE, not a passive process You are not the only one who wants something; So you have to be heard through the din of all the other interests

10. Goals 1.To win 2.T0 positively Impact Advocacy Targets 3.To build an Ongoing Capability 4.To involve your board and staff 5.To involve the community

11. Metrics 1.Can someone get the target on the phone? 2.Can you get the target to your center & how often? 3.How often is the center in the media? 4.How many local organizations/elected officials do something CONCRETE to support you? 5.How many grassroots advocates do you have? How active are they? 6.How many voters have you registered? Do they vote? 7.How much of what you ask your targets for do you get?

12. Recognition - Recognize your targets -Recognize your community supporters -Recognize your best grassroots advocates -Recognize your advocacy leaders -Recognize your center!

13. Empowering Yourself Through Advocacy Your level of commitment is directly related to your ability to make an impact. You must demonstrate personal commitment to your issues if you expect to receive the support and commitment of your officials and community members.

14. Do’s & Don’ts of Health Center Advocacy Dos: – Know What You’re Asking For – Know Your Audience – Know Your Opponents – Know The Rules – Make a Commitment – Be Polite – Say THANK YOU – Keep it Simple Don’ts: – Offer Answers You Don’t Have – Assume Knowledge of Health Centers – Believe Someone Else is Taking Care of Your Advocacy – Burn Bridges – Be Intimidated – Confuse Being Quiet for Being Polite – Express Partisanship – Forget to make your ASK

15. Making Effective Advocacy Happen: Building A Culture Of Advocacy In order to realize the full potential of our grassroots power it is critical that we create a culture of advocacy at the local, state and federal levels Building a culture of advocacy means: –Changing the culture and attitude from within the health center, recognizing advocacy as a critical and mandatory component to our daily work and planning. –Making a commitment to doing the work to build and organize our grassroots in order to fully realize the potential of our grassroots power. –Growth and recognition of grassroots advocacy and effectiveness the same way other critical skills and programs are recognized for health center staff and boards.

16. Building A Culture Of Advocacy Essentials For Empowering Your Health Center Through Advocacy in the community Recruit Advocates Inform others of your issues and advocacy efforts, ask them to get involved and make a commitment to health center advocacy. Develop Partnerships Reach out to local businesses and organizations to educate them about the health center and ask them to join in health center advocacy efforts. Increase Exposure: Begin an advocacy campaign at your health center. -Set up legislative visits at the health center with local, state, and federal officials regularly. -Write letters to the editor on health center issues. -Hold health center events -Make people (elected officials, the media, the public) aware of who you are and what you provide the community.

17. Building A Culture Of Advocacy Build And Maintain Relationships With Elected Officials Establish an ongoing schedule of hosting and meeting with local, state, and federal elected officials and their staff at the health center. Know your officials interests, background, committees, career etc. Let your officials know how many patients/ constituents you are serving and update them regularly on developments Offer yourself as an information resource to your officials and their staff. Recognize and thank your officials for their support of health centers.

18. Making Effective Advocacy Happen: Establish What Works At Your Center And In Your Community Essentials For Empowering Yourself Through Advocacy –Staying Informed- provide board members, staff, patients, and community partners with regular updates on what’s happening in D.C. and your state capital and how it could affect their center. –Ongoing Priority and Commitment- make advocacy a standing item on the agenda at every board meeting. –Recognition- publicly recognize and thank both officials and health center advocates. –Patient Involvement- involve your patients in as many advocacy activities as possible.

19. The Health Center Funding Cliff Community Health Center Funding: FY 2010 – FY 2016 $$ in Billions

20. MAKE YOUR VOICE HEARD!

21. Access is the Answer Advocacy Campaign To force Washington to fix the Health Center Funding Cliff we have launched Access is the Answer– our campaign to organize EVERY HEALTH CENTER ADVOCATE to get Congress & the Administration to fix the Health Center Funding Cliff. The goal of the Access is the Answer Campaign is to demonstrate on a massive scale, the support that local communities have for health centers. To Accomplish this Goal we are asking every Health Center to take 3 Action Steps as part of the first phase of the Campaign.

22. TODAY – April 14th CALL 866-456-3949 – TELL YOUR SENATORS TO: “Vote YES on H.R. 2 to Support HCs”! What can YOU do right NOW?!

23. Access is the Answer Phase 3 Action Steps: What can YOU do right NOW?! 1.Engage Your Health Center Board 1.Pass a Cliff Oriented Board Resolution 2.Send a Letter to Your MOCs from the BOD 2.Engage Health Center Patients & Staff 1.Collect Patient Advocate Cards 2. Launch a Staff Letter Campaign 3.Engage State Legislators & State Partners 1. Collect Individual Support Letters 2. Request Support for Sign On Letters via S/RPCAs

24. Access is the Answer: Resources Campaign Website: www.saveourchcs.org/about.cfm Templates: –English –Spanish Letter & Media Templates: –Local Elected Officials –Community Partners Report Forms Tools to Spread the Word –Bilingual Fliers –Bilingual Handouts –Social Media Tools

25. “The only way we will succeed in getting Washington to fix our funding cliff is to organize everyone in our communities –elected officials, community organizations and partners, along with tens of thousands of health center advocates, to send a forceful message to Congress and the President that folks back home not only care about making sure the Health Centers Program receives the funding and resources needed to continue providing high quality care in their communities, but that these same folks (health center advocates) reject anything short of real action to make sure that not ONE of the current 22 million health center patients lose access to care, and that millions more who still need access to care will get it.” - Dan Hawkins, NACHC Senior Vice President for Policy & Research Ultimately

26. “… The difference between what we do and what we are capable of doing would suffice to solve most of the world ’ s problems. ” -Mohandas Gandhi

27. Questions? apearskelly@nachc.com