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Advocacy in Today's Political Climate


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Advocacy in Today's Political Climate

  1. 1. Advocating for your HealthCenter in Today‟s Political Climate Douglas M. Paterson MPA Director of State Policy Michigan Primary Care Association May 22, 2012
  2. 2. Two types of organizations ◦ Those who allow others to determine the environment in which they operate ◦ Those that shape and influence the environment in which they operate Every board must decide which type they will be.
  3. 3. Build A Culture of Advocacy Change your culture to one where effective advocacy is an essential element daily work. Develop and recognize grassroots  The Essential Step: advocacy Elevate advocacy to effectiveness the the level of an same way you do organizational priority other critical skills for – for Board and Staff. health center staff and boards.
  4. 4. Advocacy versus Lobbying Advocacy – education to make policy makers more aware what you do and how policy influences your organization. Lobbying – asking legislators to take a position on specific legislation.
  5. 5. What is Grassroots Advocacy?Grassroots advocacy: the active support of a cause, issue or policy that gets its strength from the ground up rather than from the top down.Democracy is dependent upon an informed and involved electorate. It is essential that citizens have input in how their government develops policy and spends funds.
  6. 6.  All your advocacy efforts should have two goals:  Building a relationship with your elected officials and/or their staff which:  Assures you are known to the policy maker  You are viewed as a credible source of information on health center issues  Your input is valued and sought  Your calls get returned  Building the power to influence your elected officials  Create a structure that organizes your health center staff, patients and community supporters, into a machine capable of winning important issue campaigns that impact your community at the local state and national levels. Building relationships and empowering your community take time and effort over the long-term and can be more important than any single legislative issue. 6
  7. 7. 1. Advocacy Has to be an Organizational Commitment The Board Must Take the Lead – a formal commitment to time and resources is essential Create an Advocacy Committee with a Chair – Board and staff need to be included2. Advocacy Needs to be done Face to Face Plan to get your local, state and federal officials (and their staff) to your Center on a regular basis3. Advocacy Needs Numbers If 100 emails and faxes are good, a thousand is better! 7
  8. 8. 4. Advocacy Needs a Megaphone Learn how to use the media5.Advocacy Needs Friends Look for ways to reach out to other organizations in your community on a regular basis6. Advocacy Needs Votes Empower your health center by making sure your patients and staff are registered to vote and that they vote!7. Advocacy takes commitment When it comes to the government, issues don‟t go away – they just hide. Your goal is to build the permanent power to influence any issue that affects your center- at any level of government. 8
  9. 9. Things that Work Provide board members,  Publicly recognize those staff and patients information who sign up for our on a regular basis about advocacy network and who what is happening in take effective action. Washington and the state  Establish an ongoing capital and how it could schedule of hosting and affect their center. meeting with local, state, Make advocacy a standing and federal elected officials item on the agenda at every at the health center. board and staff meeting.  Find ways to involve patients in as many advocacy activities as possible.
  10. 10. Effective Advocacy = POWER Grassroots advocacy is about one thing – building power. Power is not measured by the number of advocates we have on a list. Power is not measured by the number of small (or even large) victories we win every now and then. 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.
  11. 11. Two types of Lobbying Direct Lobbying – any attempt to influence any legislation through communication with a legislator, an employee of a legislative body or government official addressing SPECIFIC legislation and reflecting views on such legislation Grassroots Lobbying – any attempt to influence legislation through an attempt to affect the opinions of the general public related to specific legislation.
  12. 12. Lobbying - preparation Know your issue – research and verify facts and background Who has interest in the legislation Why should legislator support or oppose Why is it important to your health center What facts and merit can you produce to make your case.
  13. 13. Communicating with yourlegislators – Five questionsWho am I?What is my issue?Why do I care?Why should the legislator care?What should legislator do? (Do NOT hesitate to ask the legislator if you can count on his/her support)
  14. 14. Letters Do not send form letters Be personal and unique Address legislator by name Use a subject title above name simply stating the purpose. (E.G. SB 349) Mention you live in district State your opinion and request response Be brief and clear. Keep to one page
  15. 15. Email Be short Use same care as letter Include your first and last name, your mailing address, phone number and organization Request a response
  16. 16. Phone Calls Before you call, take a moment to gather your thoughts. Write a mini-outline of what you plan to say. Identify yourself by stating your name and that you are a constituent Ask if the legislator is available to discuss (describe issue) - you will likely be directed to a staff person. Briefly educate the legislator or staff of your agency State your specific issue Keep message simple – less than four minutes Politely ask staff how the message will be conveyed ASK for a commitment Ask for any response in writing
  17. 17. Scheduling a Visit Call the legislators office and ask for scheduler Tell scheduler you are a constituent and would like an appointment to discuss (issue)
  18. 18. Meeting with Legislators Do your homework Create a packet to leave (2 copies) Bring business cards and contact info Call day ahead to confirm Be on time Always introduce yourself Don‟t make up answers to questions – if you don‟t know, tell them you will get back with them. Be sure to follow up. Present both sides of an issue in a fair and honest manner Identify others who support your position Limit the number of people you bring NEVER INTERUPT a legislator Don‟t offer opinions outside your direct concern ALWAYS TELL THE TRUTH – credibility is your capital. Ask for a commitment Ask what you can do to help the legislator Don‟t hesitate to talk to staffers – they can be good advocates.
  19. 19.  Go to and register as a health center advocate.  Advocacy/Voter Registration  Sign Up Visit the NACHC Grassroots action center 19
  20. 20.  Go to and register as a health center advocate.  Policy and Advocacy  Advocacy Center  Stay informed  Sign Up Visit the MPCA Action center 20
  21. 21. Summary It‟s about relationships!!! It takes commitment It takes effort It takes involvement It takes moxie
  22. 22. Friends of Michigan‟sCommunity Health Centers An independent political action committee representing community health centers in Michigan Collective advocacy and lobbying for high quality, culturally competent, comprehensive health care for all citizens Non-partisan Dependent on individual donations from people who believe in this cause. Goal - $500 per member center
  23. 23. National Health Center WeekAugust 5th thru August 11th.  Invite Congressional leaders, State and Local Elected Officials, Key Leaders  Events  Submit Op-Ed articles, Letters to the Editor to local press outlets
  24. 24. Questions or assistance Doug Paterson Michigan Primary Care Assoc. 7215 Westshire Dr. Office – (517) 827-0463 Cell – (517)614-0705
  25. 25. Community Health Vote 2012Non Partisan Voter Engagement at Health Centers March, 2012 Presented by Marc Wetherhorn National Advocacy Director
  26. 26. "In reality, there is no such thing as notvoting: you either vote by voting, or you voteby staying home and tacitly doubling thevalue of some Diehards vote.“ – Davis Foster Wallace
  27. 27. National Association of Community Health Centers Community Health Center Voter Engagement
  28. 28. Why Health Centers Gap in Voter Turnout by Income in recent Presidential Elections80% 77%75% 76% 72%70%65%60% 59% 59%55% 55%50% 2000 2004 2008 Below $50k $50k and above
  29. 29. Why Health Centers Gap in Voter Turnout by Ethnicity in Presidential Elections 1980 - 20080.750.650.550.450.35 1980 1984 1988 1992 1996 2000 2004 2008 White Black Hispanic Asian
  30. 30. Why Health Centers• Elections matter to the future of health centers and the health of our patients• The populations least likely to vote are OUR patients• 2/3‟s of our patients (over 12 million) are voting age• Health centers have a trusted relationship with their patients• Having more of our patients as voters dramatically leverages our advocacy power• Because WE CAN make an impact
  31. 31. Why Health Centers4 Reasons People Vote Have a Reason to Vote Have Personal contact from family, friend, nonprofit It’s Easy and Accessible A habit learned from family and community
  32. 32. Voter Engagement – Not Just Voter Registration1. Actively encourage clients and staff to register to vote2. Communicate with all, or as many clients as possible, in a non-partisan way about the importance of voting for their health and their health center3. Make voting information as visible as possible throughout the centers4. Make non-partisan voter registration an integral part of National Health Center Week activities5. Participate in National Voter Registration Day – 9/25/126. Conduct a national non-partisan get out the vote effort leading up to and on election day7. Track our results in increasing voter turnout among our clients
  33. 33. THE RULE to Remember May Not Support or Oppose a Candidate for Public Office
  34. 34. The Rules: Dos and Don’tsDO DON’TVoter Registration • Endorse a candidate forVoter Education officeDistribute Sample Ballots, Guides • Give resources to candidatesCo-sponsor Candidate Forums • Rate candidates onEducate the Candidates your issueRemind People to Vote • Tell people how to voteHelp on Election Day:Recruit Poll WorkersSupport or Oppose Ballot Questions
  35. 35. How Do We Do It - RegistrationWork with legal and voting experts to establish legal guidelines and tools to ensure compliance with federal and state lawsEstablish Community Health Vote kiosks within health centers As resources allow, provide computers and printers for self registration either directly online (where possible) or via printed forms. In other places make state or federal forms available at kiosks.Integrate or emphasize registration in public assistance enrollment at sites where this is already being done or could be doneIdentify and work with local partners to assist in the effort
  36. 36. How Do We Do It - Registration Integrate voter registration into your Health Center’s ongoing activities•Designate a staff person at each site to serve as coordinator of yourHealth Center‟s voter registration activities.•Make sure to contact your county registrar and learn any local requirements for registration or registering voters•Ask every patient at intake if he/she would like to register to vote orupdate their registration; provide a voter registration application, a“qualification form,” and a follow up enrollment card;•Ask staff, volunteers, and board members if they would like to register tovote during meetings;•Register voters at community events, especially National Health Center Week - August 5-11, 2012 National Voter Registration Day – September 25, 2012
  37. 37. How Do We Do It - Registration1. Put up posters around your health center, not just in the waiting room to let patients know that voter registration forms are available.2. Register AND Educate: Give everyone an option to get more information and to sign up as an advocate.3. Assure completed forms get submitted - provide envelopes or boxes for voter registration and advocacy forms to be dropped into upon completion. Know how long you have to turn in completed registration forms to your County registrar or Secretary of State after they are filled out. Have a staff member designated to turn in all completed forms each week, OR partner with a local community volunteer to pick up your health center’s voter registration forms.5. BEFORE YOU TURN IN VOTER REGISTRATION FORMS: Track the number of voter registration forms completed at your health center and capture information for those who want reminders and information
  38. 38. How Do We Do It - Registration“The NVRA has a provision to designate offices that provide„public assistance‟ as voter registration agencies. Publicassistance agencies include any site where an individualmay apply or receive an application for Medicaid, such asFQHCs. Under this law, FQHCs with State, city, or countyemployees as outstationed Medicaid eligibility workers areconsidered public assistance offices and must provide voterregistration services. The FQHCs that usenon-governmental employees as outstationed Medicaideligibility workers (e.g., clinic staff, volunteers) may providevoter registration services.” -BPHC Program Assistance Letter 2000-18
  39. 39. How Do We Do It - Registration Integrate or emphasize registration in public assistance enrollment at sites where this is being done• Train or educate enrollment staff on the importance of offering registration as part of this process and how to assist registrants• Provide a separate opt-in form or mechanism to allow registrants to sign up as health center advocates and/or to get ongoing voting information and reminders
  40. 40. How Do We Do it - EducationEncourage registrants to become advocates and/or to get ongoing voting information and remindersAssemble registrant contact information in a databasePeriodic email and text updates and information about voting locations times, early voting, etc.Reminders about registration and voting in some patient communicationsPeriodic “how-to” vote sessions, including early voting and voting hotlines to assist clients in votingIn states with new voter laws or ID requirements, provide information about the changes and how to comply
  41. 41. How Do We Do It – Education & GOTV• Capture registrant contact information Use Computer Interface or Manual Tracking forms Enter and/or assemble registrant contact information in a database• Send periodic email and text updates and information about voting locations, times, etc.• Provide voter information materials and signage throughout the health center• Include reminders about registration and voting in some patient communications• Periodic “how-to” vote sessions, on the mechanics of voting, including early and absentee voting and voting hotlines to assist clients in voting
  42. 42. National ResourcesFair Elections Legal NetworkNonprofit VoteTurboVoteState VoicesNational Council of La Raza
  43. 43. Elements of Success• Organizational Commitment – Board and staff understand the importance• Individual Champions – someone responsible who WANTS to make it work• A plan for implementation• Support from NACHC, PCAs & Partners
  44. 44. Important Dates• Election Day: November 6, 2012• Early Voting periods: vary by state• Registration closing dates: vary by state• National Voter Registration Day: September 25, 2012• National Health Center Week: August 5-11, 2012• Your Health – Your Voice – Your Vote Kickoff: NACHC P&I, March 21, 2012
  45. 45. Nobody made a greater mistake thanhe who did nothing because hecould do only a little. – Edmund Burke
  46. 46. The Power of Large NumbersIf every health center site registered 1new voter every business day fromMay 1 to October 6, we would registernearly 1,000,000 new voters!
  47. 47. Program Assistance Letter 2000-18 For More Information Marc 540-942-3862