Driving & Supporting Grassroots Lobbying

1. Driving & Supporting Grassroots Lobbying February 2009

2. Three Ingredients Needed for Effective Grassroots Commitment: Members/patients must be committed to make a difference in the direction of legislation. Action Orientation: Must be willingness to take action at the direction of state or national organization. Advance Preparation:Members/patients must be given the resources to respond effectively.

3. Commitment ACA has dedicated a great deal of time to educating our members and all DCs about the risks and opportunities inherent in any healthcare reform bill, ACA leaders are pushing grassroots involvement across the country. The challenge is cultivating that same commitment in chiropractic patients, whose personal interest is much more compelling to legislators. Will rely on DCs to communicate the issues to their patients, and to direct them to information and resources provided by national and state chiropractic associations.

4. Action Orientation Patients must understand that Congressional action could increase, or eliminate, their access to chiropractic services. They must also be given a simple tool to contact their elected officials to advocate for or against legislation under consideration. They will need regular reinforcement of the urgency of the situation and their empowerment to influence its outcome. Simply put, patients need to be mobilized (Carville, NCLC 2008).

5. Advance Preparation ChiroVoice, in conjunction with doctors of chiropractic, provides the education needed to cultivate commitment and action orientation, as well as the mechanism to facilitate the response to Congress. Through ChiroVoice, ACA will send monthly health and wellness resources to subscribers, as well as legislative updates and action alerts regarding health care reform issues. The goal is to ensure patients value the consumer information and thus will be receptive to the policy analysis.

6. ChiroVoice Registering at ChiroVoice takes less than two minutes, and enters the patient and his/her relationship with an ACA member into ACA’s Association Management System. Patient/doctor linkage in database reinforces the professional relationship, encouraging further commitment by subscribers. ACA can communicate via e-mail with subscribers by state or Congressional District to send targeted calls to action on bills under consideration.

7. Why ChiroVoice? • USPS no longer a reliable option (decontaminating and processing postal mail can add many weeks before USPS letter reaches Hill). • Telephone campaigns can be effective, but they are counterproductive unless both the citizen and the grassroots organization have properly prepared for the exchange. • Congressional staff rate faxes as their least preferred method of communication (43% said they had no influence at all). • E-mail messages are more effective than faxes; nearly every congressional office has reported a preference for e-mail to faxes. Source: Congressional Management Foundation, 2008

8. Why ChiroVoice? • Faxes require significant data entry and administrative work, and the tools available to congressional offices actually allow them to more quickly aggregate and report on constituent contact volumes when it is in a digital format. • In fact, of all the forms that constituent communications could take, congressional staff reported that faxes were the least likely to have an influence on Member decision-making. • When done correctly, e-mail is easy for congressional offices to process, count, and respond to, which means that communications are more effective and more likely to be acknowledged. Source: Congressional Management Foundation, 2008

9. Promoting ChiroVoice • Two-page spread in ACA News • Recurring articles in ACA News, Week in Review • Prominent placement on ACA website • Video message from Dr. Manceaux • Included in talking points used by ACA delegates • Teleconferences with state associations through COCSA • Teleconferences with individual ACA members • Facebook group and other on-line networking sites

10. Promoting ChiroVoice TIMELINE: • October 2008: • Develop ChiroVoice.org webpage • Develop ACA News launch of campaign • November 2008: • November 14-15: Joint Legislative Commission and PAC Board meeting at ACA, much attention focused on fine-tuning tactics involved in the patient network strategy. • November 18: Report to BOG on progress of the Action Plan

11. Promoting ChiroVoice • December 2008: • 1st: ACA News article on NCLC and the focus on developing a patient advocacy network • 2nd: Call with HOD outlining patient advocacy campaign • Week of December 1st: Video tape ACA leader urging support of patient advocacy network campaign • Week of December 15th: First conference call with state associations • Week of December 15th: Roll-out network with HOD and 200 other ACA DCs • 16th: Report to BOG on progress of the Action Plan

12. Promoting ChiroVoice • January 2009: • 5th Official Launch of ChiroVoice.org network via ACA News and various press releases • 5th E-mail campaign announcement to ACA members • 6th: Report to BOG on progress of the Action Plan • 8th-29th Continue campaign through ACA Week in Review • 30th Blast fax to profession encouraging participation in ChiroVoice campaign

13. Promoting ChiroVoice • February 2009: • 1st: Ongoing ACA News campaign regarding patient advocacy network • 12th: Tele-seminar with doctors and state associations • 18th: Patients start to receive newsletters • Throughout month, continue campaign through ACA Week in Review • 25-28th: NCLC, focus on ChiroVoice and grassroots integration

14. Promoting ChiroVoice • March 2009: • 1st: Ongoing ACA News campaign regarding patient advocacy network • 5th Second E-mail campaign announcement to ACA members • 12th: Tele-seminar with doctors and state associations • 18th: Patients receive newsletters • Throughout month, continue campaign through ACA Week in Review • Report to BOG on progress of the Action Plan • Further develop ChiroVoice integration throughout web (Facebook, Google, texting, etc) • 28th: Blast fax to profession encouraging participation in ChiroVoice campaign

15. Promoting ChiroVoice • April-August 2009: • 1st: Ongoing ACA News campaign regarding patient advocacy network • Mid-month: Tele-seminar with doctors and state associations • Mid-month: Patients receive newsletters • Throughout month, continue campaign through ACA Week in Review • Reports to BOG on progress of the Action Plan

16. Specific ACA Grassroots Action Regarding the Perfect Storm • Build patient data base; need at least 100,000 subscribers to have an impact on Congress. • Engage patients in the process • First Call to Action sent Feb 18 with newsletter,urging Congress to include chiropractic in all healthcare reform legislation. • Similar messages will be sent monthly until specific bills are in play. • On an “as needed” basis, subscribers will receive ACA-developed analysis of pertinent federal legislation being considered.

17. Specific ACA Grassroots Action Regarding the Perfect Storm • State Association Role • State associations are asked to actively promote ChiroVoice to their members and encourage their participation. • States have more members, and more direct contact with their members than ACA does; your support is critical to ChiroVoice’s success. • ACA may grant state associations access to patient contacts within their states for state-based advocacy efforts; this is a priority policy issue that will be addressed by BOG Thursday.

18. Specific ACA Grassroots Action Regarding the Perfect Storm • State Association Role • State associations are on the distribution list for all ACA Legislative Alerts • State associations are urged to use any Alert content in their member communications, unless specifically noted. • Steps to be taken by doctors and patients will be well spelled out in Action Alerts.

19. Implementation of Grassroots Action Using ChiroVoice • Upon identification of specific legislation requiring action, ACA will: • Notify state associations, Summit members and Key Contacts of legislation • Prepare policy analysis of bill, as well as all information obtained from ACA’s legislative contacts. • Send analysis to state associations, Summit members and Key Contacts; will ask for corroborating information from their contacts. Will revise analysis accordingly based on their feedback.

20. Implementation of Grassroots Action Using ChiroVoice • Upon identification of specific legislation requiring action, ACA will: • Prepare streamlined analysis and send to all ChiroVoice subscribers with estimated timeline for action. • Prepare messages to be sent by ACA members, and ChiroVoice subscribers through ACA’s Legislative Action Center; will distribute to state assns and Summit members for their distribution to their members. • State assns and Summit members are urged to direct their members to ACA’s Legislative Action Center to communicate with their legislators.

21. Implementation of Grassroots Action Using ChiroVoice • Upon identification of specific legislation requiring action, ACA will: • Continue to monitor progress of legislation to determine optimal timing for e-mail campaign. • Provide upon request reports of the number of messages sent to legislators to state assns and Summit members referring their members to ACA’s Legislative Action Center.

22. Key Contacts • Key Contact network a “must have;” profession lacking any viable DC-legislator network • Building a viable Key Contact program • Key Contacts are members who already have, or are willing to establish, strong on-going relationships with legislators. • They will be called upon to alert their members of Congress to important legislative issues, and to attend local events or fundraisers on behalf of the ACA PAC. • Will serve as ACA’s primary points of contact to these legislators.

23. Key Contacts • Must identify committed members to serve as spokespeople. • Existing relationships are important, but willingness to serve is more so. • Provide the tools to be successful; bill language and analysis, talking points, clear statements of association’s goals and objectives. • Communicate frequently to maintain interest and focus; develop simple reporting mechanisms for Key Contacts to report their activities. • The structure is simple; implementation is time consuming.

24. Conclusion ACA is committed to the success of our grassroots network and has dedicated significant resources to it. However, it will need the active support and promotion of state associations, Summit members and other organizations to reach the entire profession. Once established, the grassroots network will be used in both a proactive and response mode to promote our goal of chiropractic inclusion in any healthcare reform legislation and Medicare parity.

25. Conclusion After the Perfect Storm subsides, the network will remain in place, and will be maintained, to respond to other opportunities and challenges as they arise, or as the profession cultivates them. ACA wants to work closely with state associations and other interested chiropractic organizations to make this network serve the interests of the entire profession.

26. Questions? • Contact info: • ACA Department of Government Relations • 703-812-0224 • gr@acatoday.org