Hospital Advocacy 101 How to Be Heard by Lawmakers.

Hospital Advocacy 101

How to Be Heard by Lawmakers

Guiding Thoughts…“More things in politics happen by accident or exhaustion than happen by conspiracy.”

~Jeff Greenfield, Journalist

“A well-informed constituent with a specific request is the most effective lobbyist alive.”

~Thomas “Tip” O’Neill, Speaker of the U.S. House of Representatives, 1977-1987

“Anyone who thinks they are too small to make a difference has never tried to fall asleep with a mosquito in the room.”

~Christie Todd Whitman, Governor of New Jersey, 1994-2004

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Why Does Advocacy Matter?• At the local, state, and national levels, health care is

one of the most regulated fields in the nation.• More than 60% of hospitals’ patients are covered by

a government health plan (Medicare, Medicaid, etc.).• To make decisions, lawmakers rely on constituent

input…especially from constituents they know well and trust.

• Health care policy is complex. Hospital advocates can provide much-needed clarity, perspective, and wisdom.

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Hospital Advocacy 1014-

http://associationdatabase.com/aws/OCTA/pt/sp/home_page

http://www.ohiobar.org/Pages/PublicSite.aspx

http://www.ohioahu.org/

http://www.osma.org/

http://www.wbwao.org/

http://www.ohiobankersleague.com/

How to Be Heard Over the Noise

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1-Build a Relationship

2-Know the Facts

3-Time Your Request Well

4-Get to the Point

5-Present a United Front

6-Follow Up

Hospital Advocacy is an Ongoing Cycle!

How to: Build a Relationship with Your Lawmakers

• Introduce yourself as a constituent at an event.• Request a meeting at your lawmaker’s office.• Talk about your hospital and your role within it.• Invite your lawmaker to visit your hospital.• Follow up (thank-you notes, invites, infographics,

news clips on health care issues, etc.).• Stay in periodic contact. Send helpful information;

don’t make every outreach an “ask.” • Get to know the legislator’s staff.

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Common Legislative Staff Titles• Chief of Staff: Supervises other staff; serves as political advisor.• District Director: Manages the lawmaker’s district office(s).• Legislative Director: Coordinates lawmaker’s legislation and committee

work; serves as policy advisor to lawmaker and chief of staff.• Communications Director: Manages lawmaker’s relationship with the

media & public; writes speeches, press releases, social media postings.• Legislative Aide: Researches policy issues, develops legislation, works

with bill supporters. Often covers one or more broad issue categories.• Legislative Correspondent or Administrative Assistant: Logs and responds

to correspondence on legislation and public policy issues.• Scheduler: Manages lawmaker’s time, meeting requests, etc.• Caseworker or Constituent Worker: Answers questions and resolves

problems on behalf of constituents; often works with agencies to do so.• Intern or Fellow: Temporary worker who assists the above staffers.

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How to: Know the Facts• Know Yourself. Prepare a factsheet about your hospital and

your role within it.• Know the Lawmaker. Learn the lawmaker’s bio, committees,

political beliefs, etc. to know which arguments will persuade. • Know the Issue. Get the latest comprehensive summary of

the bill or issue in question; define the problem and the solution; be ready to explain why the lawmaker should act.

• Know Who’s For It and Against It. Be ready to explain why your position is the best for public policy.

• Know What You’re Asking For. Make the ask as straightforward as possible, something that’s within the lawmaker’s power, and know whether they already support it.

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Key Facts About Ohio Hospitals

• [Your hospital/system name] employs [number] people, and pays [amount] in annual payroll taxes.

• Hospitals across the state employ more than 282,000 people.

• Hospitals are a major employer in 78 of Ohio’s 88 counties.

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Hospital Advocacy 10110-

Map created in Microsoft MapPoint North America 2006 using Ohio County Profiles data from Ohio Department of Development: http://www.development.ohio.gov/research/files/s0.htm

A Major Employer in Most Ohio Counties

Hospitals are among the top employers in 78 of 88 Ohio counties….

Hospital among county’s top employers

Non-hospital health care organization among county’s top employers

Health care not among county’s top employers


• [Your hospital/system name] provides [amount in costs] of care each year for which we receive no payment.

• Hospitals across Ohio provide more than $4.5 billion of care each year for which they receive no payment.

• Ohio hospitals contribute more than $80 billion to Ohio’s economy, the 6th largest economic impact across hospitals in all states.

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• [Your hospital/system name] has reduced operational costs by [amount in costs] since [date].

• Since [date], [your hospital/system name] has reduced [category of infection, injury, or readmissions] by [amount in lives or cases].

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Where to Learn More on the IssuesOhio Hospital Association• http://ohiohospitals.org/Policy-Advocacy/

Advocacy-Network.aspxAmerican Hospital Association• http://www.aha.org/hospital-members/

advocacy-issues/action/index.shtmlOhio Legislative Service Commission• http://www.lsc.state.oh.us/

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How to: Time Your Request Well

• Lawmakers pay closest attention to issues that are in the headlines, or are scheduled for action soon (committee hearing, vote, etc.).

• Most legislators correspond by phone and email. Respond promptly to their inquiries and be mindful of holidays, recesses, etc.

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More on Timing• Mondays and Fridays often are devoted to travel or work

in the legislator’s district, and are a good time to schedule hospital or district office visits.

• For both Congress and the Ohio General Assembly, lawmakers generally are not in session in July or August.

• Lawmakers generally are not in session during election season (late September through early October of even-numbered years).

• A “Lame Duck” session, often held November through early December of election years, can bring intense, unpredictable legislative activity as lawmakers struggle to meet year-end deadlines.

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How to: Get to the Point

1. Keep it simple.

Briefly boil down the issue in layman’s terms. Then talk about its direct impact on your health care facility and your community.

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2. Stay on message.

Focus on the issue. While the discussion should flow naturally and comfortably, don’t let the conversation wander too far from the matter at hand.

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3. Use anecdotes.

Emphasize your point with stories about real people who have been (or will be) affected by the lawmaker’s policy decisions.

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4. Bring effective props.

Always bring something to give the lawmaker. It can be a recent hospital press release, an infographic, a fact sheet…but keep it brief and cogent (1 page is perfect). Include your contact info for follow-up.

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5. Ask for something specific.

Once you’ve laid out the issues and proposed solutions/action, make sure the policymaker knows exactly what you want him or her to do – whether it’s supporting a particular bill, fighting for an amendment, or persuading other policymakers to get on board.

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How to: Present a United Front

• Ohio hospitals’ best chance to improve public policy comes when they are united in common cause.

• When hospitals are divided, or inconsistent in our advocacy messages, lawmakers stop listening to us.

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“The way a team plays as a whole determines its success. You may have the greatest bunch of individual stars in the world, but if they don't play together, the club won't be worth a dime.”

~Babe Ruth

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Current Advocacy Message for State Lawmakers

Maintain Medicaid Eligibility!• Under Gov. Kasich’s leadership, Ohio expanded

Medicaid eligibility in 2013 to citizens earning less than 138% of the Federal Poverty Level.

• This has enabled more than 400,000 uninsured Ohioans to get health care coverage.

• Unless the General Assembly reauthorizes the program in 2015, those 400,000 Ohioans will become uninsured.

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Current Advocacy Message for State Lawmakers

Maintain Medicaid Eligibility! (continued)• The federal dollars to pay for expansion came from

cutting reimbursement for hospital care.• Those federal cuts to hospitals will continue whether

or not Ohio maintains current Medicaid eligibility.• Ohioans should continue to benefit from what

hospitals already have paid for; urge your state lawmakers to maintain current Medicaid eligibility.

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Current Messages for Federal Lawmakers

Share with the lawmaker:• What your hospital is doing to reduce costs, improve

quality, and provide jobs.• The challenges your hospital faces from proposed or

existing federal policies (Medicare, etc.)• A specific ask of support. More information on

current AHA calls to action: http://www.aha.org/hospital-members/advocacy-issues/action/index.shtml

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How to: Follow Up

• Within a day of a meeting, visit, or discussion with a lawmaker, send a personal thank-you by mail or email.

• Be sure to thank the appropriate staffers, too.• Briefly recap the discussion, your key points,

and the ask.• Periodically check back with the lawmaker or

staff until the issue is resolved.

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Political Action Committee

Friends of Ohio Hospitals PAC supports those candidates who understand hospitals’ challenges and can help us fulfill our mission of providing care to our

communities.

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How to Reach OHA’s Advocacy Team

• http://ohiohospitals.org/Policy-Advocacy.aspx

• To share feedback from meetings with your legislators with OHA:– Call us at 614-221-7614

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Questions and Discussion

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Hospital Advocacy 101 How to Be Heard by Lawmakers.

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