Advocacy Engagement Strategies and Best Practices

1. Advocacy Engagement Strategies and Best Practices Prepared for MONE By Tina Grant, VP, Public Policy & State Advocacy

2. “The notes I handle no better than many pianists. But the pauses between the notes--- ah, that is where the art resides” – Artur Schnabel

3. Advocacy Needs to be a System Priority – the why • Unified Voice • Catholic health care will benefit from our stronger, unified voice to advocate for better care, especially for those who are poor and vulnerable • United, we will collaborate with all persons of good will to be a transforming and healing presence in the world

4. What is Your Advocacy how and who? Leveraging the strength of CHE Trinity Health -- including its leaders, colleagues, and geographic footprint -- our advocacy program will effectively influence public policies that are critical to achieving the ministry's mission and goals.

5. Essential Elements of Health Care Transformation – the why We believe America should have a health care system that: • Provides everyone with access to health coverage and high-quality care • Coordinates care in a way that places the patient at the center of all health decisions • Rewards quality over quantity

6. Our Advocacy Strategy – A Three-Prong Approach • Building relationships with policymakers • Collaborating with like-minded groups • Educating UEM leaders, associates, and community leaders on health care transformation

7. Building Relationships • Developing a relationship with legislators and their staff • Requires some initial face to face time • Make sure you follow-up via thank you notes and additional communication on items of interest, especially important to keep in touch with the staff: Chief of Staff, Health staff, District staff • Don’t be afraid of “cold” contacts – YOU are the constituent • Show an interest in what they care about, be sensitive to their politics, seek a meeting for coffee or lunch with no real agenda. • Opportunities in the state/district: town meetings, and invite official/staff to your hospital • Lesson: A little work and persistence – big results

8. Building Relationships • Watergate story – As a young, junior staffer working in the White House, Bob Woodward struck up a conversation with a senior official of the FBI, W. Mark Felt. He maintained the relationship and years later, when Bob Woodward was working at the Washington Post, this relationship became the basis for “Deep Throat” the story we now know to be Watergate. • Lesson: The best relationships are friendships.

9. Nurses Have the “Most Trusted” Advantage According to a December 2013 Gallup Poll… Americans continue to rate registered nurses as the most trusted profession, according to this year's Gallup survey, which ranks professions based on their honesty and ethical standards.Nurses have been voted the most ethical and honest profession in America in Gallup's annual survey for 14 of the past 15 years.This year, 82% of Americans rated nurses' honesty and ethical standards as "very high" or "high," a small dip from 2012, which at 85% was  the highest rating for RNs since nurses were first included in the poll in 1999. Every legislator has a nurse as a health care provider and must know several nurses.

10. Collaborating with Like-Minded Groups • Catholic Health Association (CHA) • American Hospital Association (AHA) • State Hospital Associations • State Medical Societies • State Catholic Conferences • Enroll America • American Society of Health System Pharmacists • National Quality Forum • MONE

11. Building Collaborations • Nurses understand best the patient perspective; ie, nurse staffing ratios, education requirements, 2 midnight rule, emerging workforce needs • Think about all who will be impacted by a policy change as well as unintended consequences • Elected officials are more likely to support policy changes that have broad-base support • Lesson: When you keep patients first and collaborate with those who share this mindset, you will be influential

12. Building Collaborations • Policymaking without collaboration is doomed to failure. Clinton Health Plan as example. Decided their position and developed the details in a vacuum, sought Congressional support without input, tried to sell it to the public without sufficient validatorsLesson: Policymaking must begin with external information and communication to give it a foundation

13. Identify Unlikely Allies Medicaid Expansion in MI was a result of providers, public health groups, AARP, Small Business Association, and Chambers of Commerce aligning to build political momentum. Lesson: Ongoing networking creates goodwill and you never know when you will need to fall back on someone’s goodwill

14. Educating Leaders, Associates and Community Members • Lead the Way – Transforming America’s Health • Building support for transformative health care policy by educating targeted audiences and inspiring associate engagement • Providing a toolkit of resources to Advocacy leaders • Engaging groups in education and advocacy efforts • RHM and System office leaders • Physicians (employed and affiliated) • Colleagues • Community Members • Internet resourcesinclude e-advocacy site http://www.trinity-health.org/advocacy

15. Communicating your Message • Successful legislators will want to know more than why the position you advocate is right. Good lobbying means doing as much of the legislators’ legwork as possible, i.e. know the reasons behind the other side and neutralize opposition before they are forced to take a stand • Tell your story – make it human, emotional, and interesting. • Lesson: Tell your personal/unique story and know the other side’s story

16. Grasstops and Grassroots are Important

17. Measure and Realign Strategies Based on Outcomes Measure policy outcomes: did you achieve desired result? Measure engagement: were coalitions strong, did all members engage, did system support with grassroots, etc? Evaluate relationships: who are key legislators and how might these relationships be strengthened?