1. Making your voice count: grassroots advocacy in emergency medicine EMRA Advocacy Week 2011

2. Outline What is grassroots advocacy? How is it helpful in influencing health policy? Organizing a grassroots effort Advocacy case studies from ACEP chapters Resident grassroots advocacy activities

3. Grassroots advocacy is political activity with the goal of creating change. – Based on the power of people to take collective action on their own behalf – Federal, state, and local level

4. What are grassroots activities? Levels of grassroots advocacy: federal, state, organized medical groups, hospital Hosting house meetings or parties Educating the public on health policy issues at events Mobilizing letter-writing, phone-calling, and emailing campaigns Raising/donating money to political action committees Letters to the editor or letters to elected leaders Using online social networks to organize virtual communities

5. Advocacy?

6. Why use grassroots advocacy in health policy? Why it works.. Legislators are accountable to the constituents who elect them Lawmakers need your first-hand knowledge and expertise Individual efforts strengthen the national effort

7. Advocacy education 2010 ACEP/EMRA resolution supporting advocacy education in emergency medicine Residency education in advocacy/health policy is crucial to building leaders for emergency medicine in the future Most effective education is hands-on

8. Mobilization of grassroots effort Pick a leader Garner support of your program director/hospital Research the issues/planning phase Set goals (educational, legislative) Identifying the people who can make a difference

9. Preparing for Action Contact appropriate liaisons for help in arranging meetings (government affairs office, local ACEP chapter) Educate residents on key issues and talking points Prepare written materials for the legislator Arrange logistics of the event

10. Take action Review talking points on the day of the event Attend all meetings on time, professional appearance Have fun Invite the legislator to spend the day in the ED

11. Case study: Liability reform in Texas a. Lawsuits cause increased health care cost for all members including patients b. Fear of lawsuits can lead to defensive practices c. The costs of lawsuits can lead to reduced services, especially in areas with high litigation d. The majority of litigation money goes to the courts and lawyers, not patients e. Lawsuits do not necessarily improve patient care.

12. How could TCEP make their arguments heard? a. Collaboration with other medical, hospital and business groups as well as use of lobbyist b. Appeals to the public and lawmakers through the use of the media (press releases, interviews, letters to the editor) c. Facilitate individuals (especially doctors) to contact legislators (phone calls, letter writing) d. Monitor for submitted legislation that regarded this topic

13. Partnerships a. Other medical organizations b. Organized care organizations c. Hospital Associations d. Business and Commerce organizations What groups are likely to oppose such legislation? a. Trial Lawyers b. Some consumer advocacy groups

14. Outcome Mid 1990s- TCEP and Texas Medical Association developed proposals for liability reform 1995: reforms of the civil justice system 2003: Texas legislature passed comprehensive liability reform Texas voters approved Prop. 12

15. Improved access to care lower premiums since 2001 Decreased wait times from 2006 to 2009

16. Letters Letter to the legislator: Individualized, SNAIL or email Send on a Sunday /Monday night Letter to the editor: Small community papers: easier to publish Use a letter to the editor with legislator’s name to influence the LEGISLATOR, not the people Send it to the legislative office as well Reference the story in the newspaper (within 2 days) Short 50-100 words Use your own words

17. The perfect letter Paragraph 1: establish your standing “I serve x # of patients” (why you are important) Paragraph 2: personal story (use numbers) Paragraph 3: Include local data (research the issue) Paragraph 4: communicate passion for the issue

18. Visiting congress: Leadership and Advocacy Conference, DC

19. What else can residents do? EMRA opportunities ACEP/EMRA’s Health Policy mini-fellowship Get involved with your state ACEP or AMA chapter Go to the Council Meeting at Scientific Assembly Host a legislator to your ED for a day- contact jslade@acep.org for more information jslade@acep.org

20. Resident Lobby day Join the 911 network: http://www.acep.org/membersurvey.aspx?formi d=40334 http://www.acep.org/ Send a resident letter to your congressperson: http://www.capwiz.com/acep/issues/alert/?alertid =26650501&type=CO

21. Questions?