1. WELCOME TO THE 2011 NRHA AND POLICY PARTNERS POLICY INSTITUTE 22st Annual Rural Health Policy Institute

2. Welcome to Washington Maggie Elehwany, JD National Rural Health Association Vice-President Government Affairs

3. WELCOME TO ADVOCACY 101

4. Much change has come to Washington

5. To the White House. And to Congress.

6. And big changes come to Congress…again.

7. The Importance of Coming Together  The great impact of the Federal Government:  Legislation  Regulations (meaningful use, direct supervision, provider tax, etc.)  Funding/Appropriations

8. It means…rural America must take charge of change.

10. NRHA IS THE VOICE FOR RURAL HEALTH CARE ON CAPITOL HILL

11. Goal of Government Affairs: To be a powerful voice on Capitol Hill for Rural Health. We need YOU!!!

12. - NRHA Input is Wanted by the Hill - NRHA Testimony Testified before Every Major Health Care Committee on Capitol Hill Provided the rural voice for fighting regulatory burdens - Because of YOU the NRHA won significant victories! - We need your voice to help us continue. Capitol Hill Has Listened

13. How you can change Capitol Hill Don’t underestimate what you can do. It’s easy and you can make a difference. A phone call or e-mail can do a lot. Follow the Five Rules of Advocacy.

14. Overview/Goals  Understand the basics  Tips on how to advocate  Experience a hill visit  Know what you can do when you go home

15. What is Advocacy?  Advocacy is the tool citizens use in our democracy to bring about improvements.  But really more than that – you advocate daily  Context – legislature

16. If you can’t advocate…  Educate  You’ll hear lobby – think advocacy or go further and think educate  All you are doing is asking Members of Congress and their staff to understand your situation – they can do the rest

17. Who Advocates?  I want you to advocate!  You are your own best voice

18. The 5 Rules of Advocacy 1. Have an Ask. Know who you are asking. Make it specific. 1. Have an Ask. Know who you are asking. Make it specific. 2. Get the information to the decision-maker. 2. Get the information to the decision-maker. Ask the Congressman in person Ask the Congressman in person Go to event with Congressman Go to event with Congressman If calling: ask to speak to health care legislative assistant. (Don’t leave message with front desk.) If calling: ask to speak to health care legislative assistant. (Don’t leave message with front desk.) If Emailing: E-mail health staff directly. If Emailing: E-mail health staff directly. Joseph.Smith@mail.house.gov or Joseph.Smith@mail.house.gov or Joseph.Smith@mail.house.gov Joseph_Smith@lastnameofsenator.senate.gov Joseph_Smith@lastnameofsenator.senate.gov Joseph_Smith@lastnameofsenator.senate.gov 3. Tell the member why it’s important. How does it help his or her state or district? Personalize it. 4. Know who you educating. Is staff experienced or a newbie? 5. Be concise, polite and follow-up.

19. THINGS TO REMEMBER ABOUT HILL MEETINGS

20. Time Crunch  You will be one of many meetings today  Long hours – back-to-back  Understand this time constraint  Be concise  Be flexible  Be on time

21. Lots of issues  You will know more  They want to know what they are talking about – they’ll pretend  Explain acronyms & concepts

23. A word about staffers…  Speaking to a hill staffer  In a lot of cases, they will be younger than you expected  They are making important decisions

24. 1. Have an ask. Know who you are asking.  Don’t want to say “no”  Experts at avoiding this  Easy to get caught up into a discussion of your facility and never about how to help.  Make specific, support x.

25. Frame the Message  Here for Rural Health…  3 Points – Medicare, Appropriations, Workforce  Personalize: Make it important to them.  Imbed Data (if possible)  Stay on Message  Clear and concise

26. 2. Talk to Decision Maker  Go to event where Senator/Representative is and ask in person  Get an email or call to health staffer – leave message with health L.A. NOT the front desk  John.doe@mail.house.gov or jane_doe@senator.senate.gov John.doe@mail.house.gov jane_doe@senator.senate.gov

27. 3. Explain Importance to District  How is this important to your state/district?  Personalize it  Give your experience  They want to help their constituents

28. 4. Know who you are Lobbying  Hill staffers are usually younger than you may expect – still important  Where is bill? What committee? Is person newbie or experienced?  Don’t assume anything!

29. 5. Be Concise and Follow-Up  Be Polite!  Understand time constraint  Follow-up by email

30. Do’s and Don’ts Concise Factual Polite Punctual Understand their time constraint Give your experience!  Take their whole day  Make up things – if you don’t know, tell them you’ll get back to them  Be really late  Threaten not to vote for them

31. Putting it together  First impressions are important  Prepare Leave Behinds  Walk through material  Be attentive – ask questions to make sure they understand  Be yourself – don’t worry about mistakes

32. 5. Follow-up. Thank them  Email a thank you if met with staff. Send thank you note for Congressional member.  Don’t be afraid to periodically follow-up. Be politely-persistent.

33. NRHA Action Alerts  Easy, follow instructions  The more you respond, the better the staff will know you  The more responses, more likely Congress will act  All it is a simple call

34. Making the call  Often will leave message  Introduce yourself and explain your facility  Keep it simple and brief  Offer more info by email  Thank them  So simple!

35. Friends in high places  They care about your state  They may have graduated from your college or have kids at your high school  Overall, they are humans, you relate with humans daily

36. Invite to your facility  Invite to ceremonies – great opportunity to educate.  They want to learn about your situation  They want to be seen as doing a good thing

37. The 5 Rules of Advocacy 1. Have an Ask. Know who you are asking. Make it specific. 1. Have an Ask. Know who you are asking. Make it specific. 2. Get the information to the decision-maker. 2. Get the information to the decision-maker. Ask the Congressman in person Ask the Congressman in person Go to event with Congressman Go to event with Congressman If calling: ask to speak to health care legislative assistant. (Don’t leave message with front desk.) If calling: ask to speak to health care legislative assistant. (Don’t leave message with front desk.) If Emailing: E-mail health staff directly. If Emailing: E-mail health staff directly. Joseph.Smith@mail.house.gov or Joseph.Smith@mail.house.gov or Joseph.Smith@mail.house.gov Joseph_Smith@lastnameofsenator.senate.gov Joseph_Smith@lastnameofsenator.senate.gov Joseph_Smith@lastnameofsenator.senate.gov 3. Tell the member why it’s important. How does it help his or her state or district? Personalize it. 4. Know who you educating. Is staff experienced or a newbie? 5. Be concise, polite and follow-up.

38. The 112 th Congress  Republican Controlled House  Democratic Controlled Senate  Recession/fiscal conservative tone will create challenges

39. Right Here. Right Now.  Crucial Time in Washington D.C.  Most significant changes in health care in generations are upon us.  Billions of dollars for rural patients and providers on the line.  Health Reform,  Stimulus Bill  Appropriations.

40. Rural Advocacy, the Urgency of Now  No more opportune time for rural America to unite.  Together, our voice is strong.  So much is at stake.

41. Let’s Take Charge of Change Together.