building a culture of advocacy at your health center
TRANSCRIPT
Building a Culture of
Advocacy
at Your Health Center
Donald Hunter, MPA, BA
Membership Services Coordinator
Louisiana Primary Care Association
Understanding Who You Are and the
Culture that Created The FQHC Program
ULTIMATELY:
Leadership determines the advocacy culture.
Culture determines behavior
Behavior (“actions vs. banners in the hall") determines
Grassroots Participation =
POWER
Understanding CultureDefining Culture
a. The totality of socially transmitted behavior patterns,
arts, beliefs, institutions, and all other products of human
work and thought.
b. These patterns, traits, and products considered as the
expression of a particular period, class, community, or
population: Edwardian culture; Japanese culture; the
culture of poverty.
c. These patterns, traits, and products considered with
respect to a particular category, such as a field, subject, or
mode of expression: religious culture in the Middle Ages;
musical culture; oral culture.
He who passively accepts evil is as much involved in it as he
who helps to perpetrate it. He who accepts evil without
protesting against it is really cooperating with it.”
- Dr. Martin Luther King Jr.
"Strategy is execution,"
-Louis Gerstner, former CEO of IBM, American Express and RJR
Nabisco
"Unless you translate big thoughts into concrete steps for
action, they're pointless,"
-Larry Bossidy, former CEO of Honeywell
Health and Social Issues in America
Chronic diseases are the leading cause of death and
disability in the United States.
133 million Americans – 45% of the population – have
at least one chronic disease.
Chronic diseases are responsible for seven out of every
10 deaths in the U.S., killing more than 1.7 million
Americans every year.
Statistics from the Partnership to Fight Chronic Disease
DEFINING ADVOCACY, LOBBYING AND
GRASSROOTS ADVOCACY and LOBBYING?
Advocacy - The act of pleading or arguing in favor of
something, such as a cause, idea, or policy; active support.
Lobbying - To try to influence public officials on behalf of or
against proposed legislation.
Special Note Concerning Lobbying vs. Advocacy – to say to
someone HB543 is a disaster, doesn’t constitute as lobbying according to IRS
regulations because it doesn't recommend a specific course of action on bill
but to say HB 543 is a disaster, VOTE NO, falls into the definition of lobbying
according to IRS regulations.
DEFINING ADVOCACY, LOBBYING AND
GRASSROOTS ADVOCACY and LOBBYING?
Grassroots Advocacy - is advocacy driven by the politics of a
community. The term implies that the creation of the movement
and the group supporting it are natural and spontaneous
highlighting the differences between this and a movement that is
orchestrated by traditional power structures.
Grassroots Lobbying - is lobbying driven by the politics of a
community and like grassroots advocacy it is natural and
spontaneous not orchestrated by traditional power structures
WHAT ARE LAWS AND RULES FOR
501C3 LOBBYING?
IRS Rules - Impact your 501c3 status• Substantial Part Test - states that a 501c3 or health center
can lose its tax exempt status if in any given year a
“substantial part” of its activities are given influence legislation.
• Section 501(h) Expenditure Test
• 20% of the first $500,000 of its exempt purpose
expenditures
• 15% of the next $500,000 of its exempt purpose
expenditures
• And so on, with the maximum of $1 million dollars.
WHAT ARE LAWS AND RULES FOR
501C3 LOBBYING?
Federal Regulations – OMB Circular A-22 – Impact Federal
Funding
• Prohibited Activities - Federal grant, cooperative agreement,
cost reimbursement contract funds cannot be used to
introduce, enact, or modify federal or state legislation. These
funds also cannot be used to organize march, rally,
demonstration, letter writing campaign or to hire a
governmental relations liaison for the purpose of lobbying.
WHAT ARE LAWS AND RULES FOR
501C3 LOBBYING?
Federal Regulations – OMB Circular A-22 – Impact Federal
Funding
• Permitted Activities – Federal funds can be used to provide
technical and factual presentation or information on a federal
grant, contract, or other agreement through hearing testimony,
statements or letters to Congress. This information can only
be given when a documented request is presented.
WHAT IS THE GOAL OF
YOUR GRASSROOTS ADVOCACY?
All of your advocacy efforts should have two goals:
Build a relationship with your elected officials
and/or their staffs in which:
• You are known to the congressional office; you are
viewed as a credible source of information on health
care issues;
• Your input is valued and sought; and your calls get
returned.
WHAT IS THE GOAL OF
YOUR GRASSROOTS ADVOCACY?
All of your advocacy efforts should have two goals:
Build the power to influence your elected officials.
Create a structure that organizes your health center staff,
patients and community supporters into a machine capable of
winning important issue campaigns that impact your
community at the local, state and national levels.
Building relationships and empowering your community
take time and effort over the long-term and can be more
important than any single legislative issue.
Effective Advocacy = POWER Grassroots advocacy is about one thing – building
power.
Power is not measured by the number of advocates
we have on a list.
Power is not measured by the number of small (or
even large) victories we win every now and then.
Power must be measured by our ability to
successfully advance our own agenda and to
make it unthinkable that any other political or
special interest would ever want to take us on.
A Review of Grassroots Advocacy 101THE BASICS
Know What You Want
Know who can give it to you
Know what they want
Know how to make the loudest squeak
Advocacy is an ongoing effort
KEYS TO SUCCESSFUL ADVOCACY
Grassroots Advocacy is a Competitive Sport
There are winners and losers and, sometimes a stalemate is a win!
Advocacy an ACTIVE process, not a passive one
You are not the only one who wants something so; you have to be heard through a multitude of all the other interests.
In advocacy, it is almost always true that the wheel that squeaks the loudest gets the grease.
Rules for Organizing Grassroots
Advocacy at a Health Center
1.Advocacy and Lobbying Has to be an Organizational Commitment
The Board Must Take the Lead – a formal commitment to time and resources is essential
Create an Advocacy Committee with a Chair –Board and staff need to be included
2. Advocacy and Lobbying Has Rules
Know the Rules. It’s hard to break the rules, but you can do it if you don’t know what they are
Rules for Organizing Grassroots
Advocacy at a Health Center
3. Advocacy and Lobby Needs to be done Face to FacePlan to get your local, state and federal officials (and their staff) to your Center on a regular basis
4. Advocacy Needs NumbersIf 100 emails and faxes are good, a thousand is better!
Rules for Organizing Grassroots
Advocacy at a Health Center
5. Advocacy Needs a Megaphone
Learn how to use the media
6. Advocacy Needs Friends
Look for ways to reach out to other organizations in your community on a regular basis
Rules for Organizing Grassroots
Advocacy at a Health Center
7. Advocacy Needs Votes
Empower your health center by making sure your patients and staff are registered to vote and that they vote!
8. Advocacy Doesn’t Stop When the Whistle Blows
When it comes to the government, issues don’t go away – they just hide.
Your goal is to build the permanent power to influence any issue that affects your center- at any level of government.
Building A Culture of Advocacy Make a conscious commitment to building a
“Culture of Advocacy” at the local, state and federal levels.
To realize the full potential of our grassroots power, health centers have to change our culture to one in which effective advocacy is an essential element our daily work, and to do the hard work of really organizing our potential into real grassroots power.
Develop and recognize grassroots advocacy effectiveness in the same way we do other critical skills for health center staff and boards.
Commit to Building a Culture of Advocacyat Your Center
The Essential Step:
Elevate advocacy to the level of an
organizational priority – for Board
and Staff.
Find the Things that Work in Your
Center and Your Community
Provide board members, staff and patients
information on a regular basis about what is
happening in Washington and state capitals and
how it could affect their center
Make advocacy a standing item on the agenda at
every board and staff meeting
Publicly recognize those who sign up for our advocacy network and who take effective action
Find the Things that Work in Your
Center and Your Community
Establish an ongoing schedule of hosting
and meeting with local, state, and federal
elected officials at the health center
Find ways to involve patients in as many
advocacy activities as possible
The goal of every action
has to be to send a signal that
effective advocacy is important
and, in doing so, to train and
empower millions of people to act
on their own behalf and that of
their communities.
ULTIMATELY:
Leadership determines the advocacy culture.
Culture determines behavior
Behavior (“actions vs. banners in the hall") determines
Grassroots Participation =
POWER
There are three types of people
in the world:
The people who make things happen
The people who watch things happen and
The people who wonder what is happening
The End Thank you for your Attendance and
Participation!
Donald Hunter, BA, MPA
Membership Services Coordinator