The Important Role of Advocacy The Challenge of Governance September 2005
The Important Role of Advocacy page 1 Healthcare Trustees of New York State (HTNYS) represents the governing board members of the more than 550 not-for-profit and public hospitals, health systems, and continuing care members that comprise the membership of the Healthcare Association of New York State (HANYS). One of our most important roles at HTNYS is to support and promote the advocacy efforts of New York State s trustees on behalf of policies and programs that benefit New York State s hospitals, health systems, and hospital-based continuing care members. HTNYS will continue to prioritize advocacy as a core part of our mission to educate and inform New York State s health care trustees. The demand for government resources and changes in public policies that benefit the health care community will increase in the coming years as government continues to look for ways to streamline health care. This reality will only heighten the complex financial challenges confronting the management and governance of our state s health care community. In addition, the pressure on management and boards to provide quality services in an era of intense competition will increase. The bottom line is that it is becoming more difficult to sustain the calling and cause of our hospitals and health care facilities: providing quality health care to all, regardless of their ability to pay. For these reasons, governing boards should focus on advocacy. Governing board members, working with their chief executive officers (CEOs) and senior management, should collaborate on strategic advocacy efforts aimed at securing financial and program assistance for their institutions. In addition to planning yearly educational programs and retreats to revitalize board operations, governing boards should implement annual advocacy plans to inform, educate, and advise policymakers on their facilities needs and concerns. This document is meant to serve as a guide for health care trustees in their role as advocates. For more information, contact HTNYS at (800) 360-7211.
The Important Role of Advocacy page 2 Grassroots Advocacy: Your Voice Is Important! One of the most important roles a trustee has as a community health care leader is to advocate on behalf of the health care institution. The role of advocate is a powerful one. When state or federal policymakers hear from a volunteer trustee on an issue of importance to the local hospital or health care provider, they take notice. Getting a telephone call or visit from the local bank president, who just happens to be the board chair of the local hospital, sends a very powerful message. Becoming an effective health care advocate is one of the most vital skills trustees can develop. New York State s hospitals and health care providers are under constant pressure to maintain high quality health care, while coping with severe financial constraints. The end result is that our hospitals, health systems, and continuing care providers are continually faced with the challenge to do more with less. Policymakers at the federal and state levels often enact legislation that curtails health care financing without any real understanding of the impact these changes have on the local health care facilities and the patients they serve. By working with your facility s management, and especially the chief executive officer, you can be a valuable asset in helping to deliver the message that brings home the impact of legislative proposals on the local hospital or health care provider. The Power of Trustees Everyone is Recognizing It In recent years, a growing number of state and national organizations have recognized that trustees can and should play a more visible role in advocacy. The American Hospital Association (AHA) has long recognized the power of trustees, and has been putting increased emphasis on efforts to educate the nation s trustees about the vital role they can have in advocacy initiatives at the federal level, as well as in their own community. We view trustees as a very important part of our grassroots efforts, says Barbara Lorsbach, AHA Senior Vice President. Even governance consultants are strong proponents of the role that trustees need to have as advocates on behalf of their health care organizations. Jamie Orlikoff, President of Orlikoff & Associates, Inc., and a senior consultant with the Center for Healthcare Governance, states, Trustees need to recognize that grassroots advocacy is a board responsibility. Trustees need to be engaging the community in thoughtful discussion on health care and the implications for the local hospital of national health care policy issues. The more the community understands, the more they will support the hospital.
The Important Role of Advocacy page 3 Community Advocacy In Your Own Backyard When trustees hear that they need to step up their role as an advocate on behalf of their organization, they often think that they are expected to make a telephone call or visit a lawmaker. While this represents a critical part of the trustee role as an advocate, it is only part of the job. As a trustee, one of the most important contributions you can make is to communicate a message as an ambassador to your own community. This is particularly valuable and important when your organization is in the middle of a transition or major change that affects patient care. In times of change, the voices of trustees can be a calming influence that can assure a community that is receiving accurate information about a transition ahead. Trustees can also be effective and proactive in their health care organization s efforts to win community support for an expansion project or other, possibly controversial, initiative. Never underestimate the power of the voice of a trustee, who represents the interests of the community. Trustees also can be extraordinarily effective when they speak with media especially newspaper editorial boards and reporters on issues of concern to the community. When prepared with the right information and message points, trustees can make excellent spokespersons on behalf of health care organizations. Trustees can use their personal strengths to make a difference in public policy issues. For example, when communicating the economic benefit of your organization to the community, it makes sense to use a trustee on your board that has a business background since they can make an even stronger argument for the business case for a strong, stable hospital in the community.
The Important Role of Advocacy page 4 What Makes a Trustee Advocacy Message so Important? You are a local entity and homegrown. Policymakers tend to be the most responsive to their constituents, who are directly responsible for keeping them in office. You represent an important local institution. The local hospital or health care provider is an enormous economic and community resource, and maintaining its financial well being is a priority for local, state, and federal policymakers. They do not want to see the local hospital suffer on their watch. Your role as a volunteer steward of a community health care provider carries weight. When you take the extra step of making a call or a personal visit to a policymaker as part of your board duty, legislators take notice. You are viewed as having credible, unbiased information. Your message about the impact of a policy or proposal on the bottom line of an institution provides valuable insight to policymakers that carries authority because it comes directly from the boardroom. Board members are trusted community and business leaders. Frequently, trustees have responsibility for important community interests that are separate from their duties as members of health care governing boards. For this reason, they are often already well known to policymakers. Health care trustees are not being paid to advocate, and they have no economic stake in the success of their institution. Trustees are dedicated because of their commitment to the institution as a community resource. This makes their voices unique and powerful.
The Important Role of Advocacy page 5 How to Effectively Communicate Your Message Once you get the ear of your legislator, how can you make sure that you make the most out of the meeting? Most legislators are not experts on health care policy, are extremely busy, and need quick, easy answers to complex policy questions. How can you make the most out of your visit or telephone call? Keep it simple. Don t worry about the specifics of the bill or regulation. Spend your time talking about the issue and its direct impact on the health care facility. Stay on message. Policymakers love to chat and catch up on the local news, but remember you have limited time to deliver an important message about your facility. Use anecdotes. Compelling stories that resonate the most tend to be the anecdotes that spell out, in explicit detail, the impact of a policy or proposal. Bring props. Does your facility s most recent financial statement reinforce your point? Bring it along and highlight the bottom line information. Legislators love specific information that provides facility-specific details. Speak from the heart. Your best weapon is your passion as a community volunteer, speaking on behalf of the facility. Ask for something specific. Don t end your conversation without asking for something in return. While your visit is important, as soon as you are out the door, the legislator is moving on to the next appointment. Before you leave, make sure you have left the ball in his or her court, with a deliverable expected. Be clear as to what you want, whether it is their co-sponsorship on an important bill, a letter on a regulation, or a call to a legislative leader on behalf of your concerns. Follow up! Make sure you follow up to ask what has been done on your request for action.
The Important Role of Advocacy page 6 Six Things You Can Do Today As a Health Care Trustee Advocate Request a Meeting. Contact the district office or Albany or Washington, D.C.-based office of the legislator to request a meeting. Ask to speak with the person in charge of scheduling. Introduce yourself, explain why you want the meeting, and ask the scheduler to arrange it. Be flexible, but persistent. Write a Letter. Even with advances in communications technology, the time-tested method of writing a letter is still an effective way to communicate your message. Keep it to less than two pages. Always begin with an expression of thanks for past actions or support. Ask for a response and for a specific action (co-sponsorship of a bill, etc.). Make a Telephone Call. Personal calls, particularly if you have a good, personal relationship with the policymaker, can be extremely effective in delivering your message. If the legislator is not available, talk with the chief of staff or health care aide, who can be very helpful in making sure your message is heard. Invite Your Legislators to Visit Your Facility. Visiting your facility is one of the best ways to drive home the message to your legislators. Always include a tour that illustrates the impact your facility has on the health and well being of the legislator s constituents. Make sure you allow time for the legislator to meet and talk with key hospital staff. Make arrangements to photograph the visit and always offer to coordinate with the legislator s press office. If your legislator cannot visit, extend the offer to key staff in his or her office. Sometimes a visit with staff can be as productive since legislators tend to rely heavily on the advice and counsel of their staffers. Organize a Meeting with Your Local Editorial Board. One of the most effective ways to communicate a message is to work with the editorial board of your local newspapers. Educating the opinion writers of your local newspaper on the impact of an issue or proposal on your institution can be very valuable in raising public awareness. To prepare for these meetings, always be very clear about your message, and be prepared for tough questions. Always work with your CEO and hospital management and offer specifics the help to illustrate your point. Work with Other Board Members. There is strength in numbers and the more governing board members involved in your advocacy cause, the better. Work with your CEO to establish a group of board members who can serve as an effective advocacy team.
The Important Role of Advocacy page 7 The Importance of a Healthy Political Action Committee (PAC) Nothing can take the place of good old-fashioned grassroots lobbying. An effective and healthy political action committee (PAC) assures strategic political access to policymakers. A strong PAC, combined with grassroots advocacy, is necessary to assure any successful government relations effort. The key to successful PAC fundraising is the commitment of the individuals that support it. The HANYS PAC/New York State Hospital and Healthcare Associations Federal PAC is one of the most successful health care PACs in New York State, largely because of the hundreds of individuals, representing hospitals and health systems across the state, that support it. Solicitation for contributions is limited to the executive, administrative, and salaried personnel of HANYS member institutions. Beginning this year, due to a recent change in federal election regulations, health care trustees of HANYS members can be directly solicited for PAC contributions. A portion of each contribution goes to support federal activities, through the PAC of the American Hospital Association (AHAPAC). The remainder is used by the HANYS PAC and the New York State Hospital and Healthcare Associations Federal PAC to help secure support for issues of concern to candidates from state and federal elected offices. The input of health care leaders in each region of the state helps the PAC contribute to candidates that share the goals of the membership of HANYS, HTNYS, and the regional associations. For more information on the HANYS PAC, contact Steven Kroll, HANYS Vice President for Governmental Affairs and External Relations, at (518) 431-7727. We Want to Hear About What You Are Doing! Please tell us about your health care organization s advocacy initiatives. We want to know of your outreach and of the response that you receive from lawmakers, the media or your community. For more information on HTNYS advocacy activities, contact us at (800) 360-7211 or at jcunning@hanys.org.
09-05 HEALTHCARE TRUSTEES OF NEW YORK STATE One Empire Drive / Rensselaer, NY 12144 / (518) 431-7999 / www.htnys.org