This document provides a comprehensive overview of advocacy and lobbying as crucial components for community health centers in Michigan, emphasizing the importance of grassroots advocacy to influence policy and build relationships with elected officials. It distinguishes between advocacy and lobbying, outlining strategies and best practices for effective engagement with legislators, including relationship building, communication techniques, and the significance of organizational commitment. The document also highlights the essential role of a culture of advocacy within health centers, urging collaboration and ongoing education to ensure sustained influence in policy matters.

1. Advocacy Training: Are you in the Driver’s Seat? Michigan Primary Care Association Doug Paterson – MPCA Chris Kilgroe – Representative Mary Valentine’s Office Promoting, supporting, and developing comprehensive, accessible, and affordable community-based primary health care services to everyone in Michigan.

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. 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.

4. ADVOCACY

5. 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.

6. 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. Participatory democracy : when taxpayers have input in how their government develops policy and spends funds.

7. All your advocacy efforts should have two goals: Build 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 Build 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.

8. KEYS TO SUCCESSFUL ADVOCACY Grassroots Advocacy is a Competitive Sport There are winners and losers and sometimes a stalemate is a win! Advocacy an ACTIVE process, not a passive one You are not the only one who wants something so you must be heard above all the other interests. In advocacy, it is almost always true that the wheel that squeaks the loudest gets the grease.

9. Make a conscious commitment to building a “Culture of Advocacy” at the local, state and federal levels to realize the full potential of our grassroots power, health centers have to: Change our culture to one in which effective advocacy is an essential element our daily work, and to do the hard work of really organizing our potential into real grassroots power. Develop and recognize grassroots advocacy effectiveness in the same way we do other critical skills for health center staff and boards.

10. 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 included 2. Advocacy Has Rules Know the Rules. It’s hard to break the rules, but you can do it if you don’t know what they are 3. 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 basis 4. Advocacy Needs Numbers If 100 emails and faxes are good, a thousand is better! (It took 1 million emails to save Big Bird!)

11. 5. Advocacy Needs a Megaphone Learn how to use the media 6.Advocacy Needs Friends Look for ways to reach out to other organizations in your community on a regular basis 7. Advocacy Needs Votes Empower your health center by making sure your patients and staff are registered to vote and that they vote! 8. Advocacy Doesn’t Stop When the Whistle Blows 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.

12. The Essential Step: Elevate advocacy to the level of an organizational priority – for Board and Staff.

13. Provide board members, staff and patients information on a regular basis about what is happening in Washington and Lansing and how it could affect their center Make advocacy a standing item on the agenda at every board and staff meeting Publicly recognize those who sign up for our advocacy network and who take effective action Establish an ongoing schedule of hosting and meeting with local, state, and federal elected officials at the health center Find ways to involve patients in as many advocacy activities as possible

14. LOBBYING

15. 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.

16. Legislator’s job Conceive legislation Develop support Study issues Vote on legislation Appropriate funding Develop expertise on subjects related to committee assignments Attend sessions and committee meetings Exercise legislative oversight Communicate with constituents Assume active role in district Play active role in political party Participate in ceremonial local and state functions May maintain a district office GET ELECTED

17. 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.

18. Communicating with your legislators – Five questions Who 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)

19. 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 Be brief and clear. Keep to one page

20. Email Be short Use same care as letter Include your first and last name, your mailing address, phone number and organization Request a response

21. 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

22. 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) Invite legislator to visit your clinic

23. 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.

24. Testifying Committee hearings are an important part of the legislative process Briefly introduce yourself State your goal and major points Support your position Personalize your testimony List your specific recommendations Be as specific and brief as possible Bring 30 copies

25. The Fringe Benefits of Lobbying Helps to develop true constituencies Helps develop new leadership Helps educate the public Democracy – in a participatory democracy, a policy debate reflects what the participants bring to it. If only those with self interests are heard policy makers lose the benefit of an important perspective. Those without a voice get heard.

26. Go to www.NACHC.com and register as a health care advocate Go to www.MPCA.net and register as a health care defender Take action: When you receive an action alert CALL-EMAIL or FAX whatever you can Invite your legislators to your center

27. Primary Care Cares PAC The independent committee representing community health centers in Michigan Collective advocacy and lobbying for high quality, culturally competent, comprehensive health care for all citizens Non-partisan and Independent Dependent on individual donations from people who believe in this cause. Goal - $500 per member center

28. Prohibited donations Cash over $20 Anonymous Donations Contributions from corporations, joint stock companies, labor organzations, or Indian Tribes Donations over certain amounts $5,000 for Represenatative $10,000 for Senator $10,000 for local or Judicial seat

29. Make an organizational commitment to advocacy Board Meetings Promote with staff and patients Support the PAC Primary Care Cares c/o Doug Paterson 2701 Heather Dr East Lansing, MI 49923 Take ACTION SUMMARY

30. Questions or assistance David Brown Doug Paterson 15175 Dixie Hwy Suite D Michigan Primary Care Assoc. Monroe, MI 48161 7215 Westshire Dr. Office – (734) 384-7000 Lansing, MI 48917 Home – (734) 243-2378 Office – (517) 381-8000 X 209 [email_address] Cell – (517)614-0705 [email_address]