1. Iowa Nurses Association Legislative/Lobby Day February 16, 2012 Healthcare Policy: Sharing Our Voice Eastern Iowa Chapter (EIC) of Oncology Nursing Society

2. How can Nurses Influence Health Care Policy? by Linda Moeller, BSN RN, Chapter Legislative Liaison

3. The Nurse as Advocate You ask me why I do not write something.... I think one's feelings waste themselves in words, they ought all to be distilled into actions and into actions which bring results. - Florence Nightingale

4. Nurses Can Influence the Health Care Policy Debate The difference between “advocacy” and “lobbying” – Public policy issues (e.g., the government should support preventive health care) vs. specific legislation (a bill that requires insurance companies to pay for the cost of cancer screening) Lobbying = encouraging the passage, defeat or modification of specific legislation. Any citizen, acting in their personal interests can directly lobby a legislator about a bill or law. Advocacy = a process of activities designed to influence public policy debates and resource allocation by elected officials. Advocacy includes thing such as media campaigns, legislative lobbying, public speaking, etc.

5. Nurses Can Influence the Health Care Policy Debate (Continued) Why policymakers need nurses – Very few elected officials/policy makers are nurses – Nursing is recognized as the most ethical and honest of professions (Gallup Annual Honesty and Ethics Survey) This is the time for nurses to take an advocacy role – The Affordable Care Act – Institute of Medicine/Robert Wood Johnson Foundation Report on “The Future of Nursing Leading Change, Improving Health”

6. The Affordable Care Act Extends coverage to up to 34 million people uninsured, including children up to age 26 Mandates individual and employer coverage Prohibits insurance companies from denying coverage in certain situations Creates state and federal insurance exchanges Supports development of the health care workforce

7. Report on “The Future of Nursing Leading Change, Improving Health” Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States

8. Meeting Policy Makers Meeting time with elected officials and policy makers may be tight – it is important to get your key points out early and often. Elected officials and policy makers may need to be educated on health care issues.

9. Tips for an Effective Visit with Policy Makers Be organized and recognize the importance of the policy maker’s time Know what you want to say – be brief and clear Anticipate questions and listen carefully Reference personal examples and relevant local data Discuss outcomes/consequences if no action taken Receive a commitment for a time to follow-up and leave contact information Offer your thanks, obtain the policy maker’s contact information and follow-up with a thank you letter and telephone call

10. The Value of Constituent Meetings and Communications Constituent meetings, letters, e-mails and other direct communications make legislators and policy makers more responsive to their constituents. Individual visits and letters/e-mails written by individuals are more persuasive than “generic” mass-produced letters and e-mails.

11. Why Legislators Like Nurses Nurses can be trusted and understand the “big picture” issues of health care. Nurses have a first-hand and direct bedside understanding of patient (constituent) needs. Nurses are tenacious and reliable. Nurses are on the side of patients (constituents) and not on the side of health care profits

12. An Example of Oncology Nurse Advocacy Colon cancer is the second leading cancer killer; appropriate screening can lead to early detection and successful treatment. 30 states and Washington DC have passes laws that support insurance coverage for colon cancer screening; the state of Iowa, however, does not mandate full coverage of colon screening by insurance providers. Requesting Iowa legislators to introduce and support such legislation.

13. How can I Become Involved? Participate in nursing organizations and patient interest groups – ONS – webpage has link to legislation and advocacy (http://www.ons.org/LAC)http://www.ons.org/LAC – Iowa Nurses Association – webpage link to public policy issues (http://www.iowanurses.org/)http://www.iowanurses.org/ – Lance Armstrong’s Livestrong Action – One Voice Against Cancer (http://www.livestrong.org/Take- Action)http://www.livestrong.org/Take- Action

14. ONS-Supported Legislative and Regulatory Proposals If ONS is asked to take a position on a legislative or regulatory proposal, its Board of Directors reviews the proposal and decides whether not to support the proposal based on the following factors: – ONS mission, goals and objectives; previous policy positions ONS has taken in the past, ONS health policy agenda priorities for the current year; and the role that ONS and oncology nurses would play in the particular issue or policy being proposed.

15. Conclusion: The Importance of Nurse Advocacy “Unless we are making progress in our nursing every year, every month, every week, take my word for it we are going back.” – Florence Nightingale