Health Policy Advocacy:
How You as a Nursing Leader
can Bring About Change
Leslie Greenberg, RN, MSN, OCN®
Health Policy Manager
Oncology Nursing Society
Objectives
•Identify the ONS Health Policy Agenda
•Distinguish between “grass roots” and
“grass tops” approaches
•Identify how you as leaders can take an
active role in bringing about change
Why Be Involved?
•Nurses have power in knowledge
•Nurses have power in numbers
•Nursing has the power of the profession to
shape health care
•Nurses have the power of being a true
patient advocate
There Ought to be a Law!!
Turning Outrage Into Action
TYPES OF ADVOCACY
Patient – doing what oncology nurses do everyday
Legislative – impacting the proposed laws and amendments
being considered by the Congress
Regulatory – seeking to influence the rules and regulations
that implement federal laws (e.g., submitting comments to the
Centers for Medicare and Medicaid Services)
Media – using the media to influence public policy
deliberations (e.g., op-eds, TV or radio ads)
Legal – employing lawsuits to effect change (e.g., suing the
tobacco industry)
Ways to Impact Public Policy
•Direct “lobbying” (ONS Health Policy Manager
and Associates)
•Grassroots advocacy (ONStat – ONS members as
constituents)
•“Grasstops” advocacy (ONS staff and volunteer
leaders and REACH Team members)
•Media advocacy (e.g. LTEs, ads, op-eds, etc.)
•Coalition work
•Involving “patients” as advocates
Setting ONS’s Annual Health
Policy Priorities
Five factors taken into consideration
when reviewing issues:
(1)
(2)
(3)
(4)
(5)
ONS mission
ONS goals & objectives
ONS positions/policies
Is there a unique role for ONS to play?
What is the political environment?
Setting ONS’s Annual Health Policy Priorities
Annual timeline:
December – ONS Health Policy Manager reviews the
current agenda and revise it based on Congressional
action, emerging issues, and political landscape
January – ONS Health Policy Manager presents the revised
agenda to – and discuss it with – the ONS Board of
Directors which suggests changes
February – ONS Health Policy Manager make final
edits/modifications to the agenda and ONS Board gives
its final approval
February through December – ONS Health Policy Manager
and Associates work to implement the agenda
ONS 2008
Health Policy Priorities
Three thematic areas of focus:
1.
Bolster the Nation’s Nursing Workforce to Safeguard
Public Health
2.
Advance and Ensure access to Quality, Comprehensive
Cancer Care
3.
Promote and Prioritize Tobacco Cessation
ONS 2008
Health Policy Priorities
Bolster the Nation’s Nursing Workforce to Safeguard
Public Health
• Boost Funding for Federal Nursing Workforce Programs
• Ensure Advanced Practice Nurses Can Provide Care
Under Federal Programs
• Expand Nursing School Faculties to Meet Current and
Expected Needs
ONS 2008
Health Policy Priorities
Advance and Ensure Access to Quality, Comprehensive
Cancer Care
• Increase and Ensure Sufficient Medicare
Reimbursement for the Full Range of Cancer Care
and Oncology Nursing Services
• Enact the Genetic Information Nondiscrimination
Act
• Ensure Access to Clinical Trials
• Boost Funding for Cancer Research, Prevention,
Education, Awareness, and Control Programs
ONS 2008
Health Policy Priorities
Promote and Prioritize Tobacco Cessation
• Enact the Family Smoking Prevention and Tobacco
Control Act to grant the Food and Drug Administration
(FDA) the authority to regulate all tobacco products
• Ensure Access to Tobacco Cessation Therapies and
Counseling
Other Congressional Action on Health Care
• Permitting the federal government to negotiate
Medicare Part D prices with pharmaceutical
• Expanding federally funded stem cell research
• Reauthorizing the State Children’s Health
Insurance Program
• Reforming Food and Drug Administration
(FDA)
ONS Coalition Activities
• Appropriations
• Nursing policy and practice issues
• Tobacco control
• Research matters
ONS Appropriations Coalition
Activities
• National Coalition for Cancer Research
• Americans for Nursing Shortage Relief
• Health Professions Nursing Education
Coalition
ONS Nursing Policy & Practice
Coalition Activities
• Americans for Nursing Shortage Relief
• Coalition for Patients’ Rights (focused on
state level scope of practice attacks)
• Informal coalition of advanced practice
nursing organizations and interests (e.g.
ACNP, NAPNAP, etc.)
ONS Tobacco Control Coalition
Activities
• Partners for Effective Tobacco Control
• Campaign for Tobacco-Free Kids
• Other public health organizations (e.g.
American Public Health Association)
ONS Health Policy Advocacy
Representatives & Leaders
• ONStat – ONS electronic grassroots
advocacy program
– If an ONS member in good standing and have
an email address, you can join
– Complete an ONStat form tonight or
– Change your profile settings on-line at
www.ons.org
• State Health Policy Liaisons
ONS Health Policy Advocacy
Representatives & Leaders
• Capitol Gang – ONS members in the
greater DC area who volunteer to assist
with local health policy activities on an asneeded basis
–
–
–
–
ONS member in good standing
Live within a few hour drive to Capitol Hill
“Trained” in advocacy
Able to represent ONS well at public events
such as hearings, coalition meetings, etc.
ONS Health Policy Advocacy
Representatives & Leaders
• REACH Team – Recruiting, Educating, Advocating and
Communicating Health Policy
– Piloted in 2006 in select states to cultivate “grasstops” ONS
leaders to develop relationships with key Congressional
offices:
• California
• Florida
• Iowa
• New York
• North Carolina
• Ohio
• Pennsylvania
• Texas
ONS Health Policy Advocacy
Representatives & Leaders
• ONS Staff and Board Members
– ONS President, President Elect and CEO travel to DC a few
times a year to visit Capitol Hill
– ONS Board Members reach out to their Members of Congress to
develop relationships and garner support for ONS priorities
• ONS Health Policy Manager and Associates
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–
–
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Engage in direct lobbying
Participate in coalition activities
Support and assist ONS advocates
Monitor legislative and regulatory activities
Develop resources, correspondence, regulatory comments,
action alerts, etc.
How to Support
ONS’s Health Policy Priorities
Join ONStat and Help Recruit Others
• ONS’s grassroots electronic advocacy network makes it easy and
effective to weigh-in with elected officials
• The Legislative Action Center – www.onslac.org – does all the work for
you – pulls up Members of Congress, gives you a template e-mail, and
with a click of a button, sends the message directly to Capitol Hill
• Complete the ONStat form today
• Ask your colleagues to complete a form and/or change their email
preferences under their ONS profile on-line
How to Support
ONS’s Health Policy Priorities
Respond to ONS Action Alerts and Distribute Them to Others
• All e-mails, faxes, letters, calls, postcards, petitions, etc. are
counted
• Personal handwritten letters suggest a high level of priority
and importance (send by fax or hand-deliver to local offices)
• Keep a copy of your message in case you need to follow up
• Anyone can use the ONS Legislative Action Center, so share
the information with colleagues, family, and friends
How to Support
ONS’s Health Policy Priorities
Call Your Members of Congress
• Phone calls allow you to weigh-in directly and quickly,
particularly on an urgent matter – just be sure to ask for a
response, and give you contact information to the staffer
• Just dial the Capitol switchboard: 202-224-3121, and ask to be
transferred to your Senators, or your Representative
* Not sure who represents you – just put your zip code in the
Write to Congress/Find Your Reps portal box at
www.onslac.org, and the Legislative Action Center will give
you your state and district-specific information
How to Support
ONS’s Health Policy Priorities
Meet with Your Elected Officials
In person meetings are very effective and send
a message that you are engaged in the
public policy process and will hold your
elected officials accountable
How to Support
ONS’s Health Policy Priorities
Establish a relationship with Elected Officials
and/or Their Staff
•
It is easier than you think to get to know your elected
officials – seek a meeting, follow-up with a thank-you
letter, and communicate regularly (but not too often)
•
Taking the time to become acquainted with Members
of Congress and their staff helps ensure that when you
email, call, write, or visit in the future that your input is
valued highly
Have Your Voice Heard at Home
• Attend a town hall meeting
• Submit an op-ed piece or
letter-to-the-editor to your
local newspaper
• Visit the local offices of your
elected officials or invite them
to attend a chapter meeting
• Register and vote!
COMMUNICATION:
TOP 10 TIPS
1.
2.
3.
4.
Be Clear, Brief, Polite, & Honest
State Up-front What You are Requesting
Include a Personal Example
Give Evidence and Use Local Data (not too
much) to Illustrate the Issue/Problem
5. Discuss Positive Effects of Taking Action
and Consequences of Not Taking Action
COMMUNICATION:
TOP 10 TIPS
6.
7.
8.
9.
Repeat the Point
Be a Resource & Offer to Help
Ask Clearly for Action/Response
Express Your Appreciation for Time/Attention to
Your Concerns
10. Follow-Up and Thank Instead of “Spank”
**
Keep a Copy of Your Letter/E-mail, and Record Who
You Spoke With in the Office
ONS On-Line Resources
• ONS Advocacy “101” Course for CEU –
http://onsopcontent.ons.org/education/Advocacy/index.shtml
• ONS Capitol Connection – Monthly ONS Connect Column http://www.ons.org/publications/journals/connect/index.shtml
• ONS Capitol Gang - http://www.ons.org/lac/pdf/capitolgang.pdf
• ONS Legislative Action Center – www.onslac.org
• ONStat – ONS Grassroots Electronic Advocacy Network http://www.ons.org/lac/onstat.shtml
• ONS State Health Policy Liaisons http://www.ons.org/lac/shpl.shtml
• ONS REACH Team Pilot Project – CA, FL, IA, NC, NY, OH, PA, and
TX - http://www.ons.org/lac/chear/oct06/chear1.shtml
Recommended Health Policy Websites
• Agency for Health Care Research and Quality – www.ahcpr.gov
• American Academy of Nurse Practitioners Legislation and Practice
http://www.aanp.org/Practice+Policy+and+Legislation/Practice+and+
Policy.asp
• American Cancer Society – Get Involved
http://www.cancer.org/docroot/GI/gi_0.asp
• American College of Nurse Practitioners Public Policy Information
www.nurse.org/acnp/leg/index.shtml
• American Nurses Association Government Affairs
www.nursingworld.org/gova/
• Cable News Network (CNN) Politics – www.cnn.com/POLITICS
• Cable Satellite Public Affairs Network - www.c-span.org
• (US) Centers for Disease Control and Prevention – www.cdc.gov
• Centers for Medicare and Medicaid Services – www.cms.hhs.gov
Recommended Health Policy Websites
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(US) Congress – http://thomas.loc.gov
Congress.org – www.congress.org
Congressional Quarterly (one of the most read periodicals on
Capitol Hill) – www.cq.com
(U.S.) Department of Health and Human Services –
www.dhhs.gov
Democratic National Committee – www.democrats.org
Federal Register – www.gpoacces.gov/fr/
(US) General Accounting Office - www.gao.gov
(US) Government Printing Office – www.access.gpo.gov
Health Resources and Services Administration – www.hrsa.gov
(US) House of Representatives – www.house.gov
League of Women Voters – http://www.lwv.org
National Association of Counties – www.naco.org
National Association of Pediatric Nurse Practitioners www.napnap.org (click on Advocacy)
Recommended Health Policy Websites
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National Cancer Institute – www.nci.nih.gov
National Conference of State Legislatures – www.ncsl.org
National Council of State Boards of Nursing – http://www.ncsbn.org
National Governors Association – www.nga.org
National Institutes of Health – www.nih.gov
National Journal (one of the most read periodicals on Capitol Hill)
www.nationaljournal.com
Project Vote Smart – www.vote-smart.org
Republican National Committee – www.rnc.org
Roll Call (one of the most read newspapers on Capitol Hill)
www.rollcall.com
Roster of National Nurse Practitioner and Nursing Organizations
www.nurse.org/acnp/resources/index.shtml
(US) Senate – www.senate.gov
U.S. Conference of Mayors – www.usmayors.org/uscm/home.asp
White House – www.whitehouse.gov
ONS National Office
Support
Leslie Greenberg
Health Policy Manager
lgreenberg@ons.org
412-859-6401
Christina Ryan
Executive Team
cryan@ons.org
412-859-6360
ONS Health Policy Associates
Washington, DC
Ilisa Halpern Paul, MPP
ilisa.paul@dbr.com, 202/230-5145
Jeremy R. Scott
jeremy.scott@dbr.com, 202/230-5197