Advocating on Behalf of Oncology Nurses and People with Cancer Ilisa Halpern Paul, MPP Managing Government Relations Director ONS Health Policy Associate.

Advocating on Behalf of Advocating on Behalf of Oncology Nurses andOncology Nurses andPeople with CancerPeople with Cancer

Ilisa Halpern Paul, MPPManaging Government Relations Director

ONS Health Policy AssociateDrinkerBiddleGardnerCarton

ONS Pre-Congress Special Interest Group ONS Pre-Congress Special Interest Group LiaisonLiaison

Leadership OrientationLeadership OrientationApril 23, 2007April 23, 2007

There Ought to be a There Ought to be a Law!!Law!!

Turning Outrage Into ActionTurning Outrage Into Action

TYPES OF ADVOCACYTYPES OF ADVOCACY

Patient – Key Role of NursingPatient – Key Role of Nursing

Legislative – Proposed New Laws, Legislative – Proposed New Laws, Programs, and PoliciesPrograms, and Policies

Regulatory – Implementation of Regulatory – Implementation of LawsLaws

Media – Print, T.V., Radio, Websites, Media – Print, T.V., Radio, Websites, and Blogsand Blogs

Legal - LitigationLegal - Litigation

Who Am I to lobby Congress? Who Am I to lobby Congress?

I am “just”a nurse.I am “just”a nurse.The Constitution grants you the right “to petition The Constitution grants you the right “to petition the government for a redress of grievances.”the government for a redress of grievances.”

Congress Plays Health Professional – you are one Congress Plays Health Professional – you are one and they need your expertise!and they need your expertise!

They Work for YOU!They Work for YOU!

Washington, DC Washington, DC Legislative StaffLegislative StaffPolicy FocusPolicy Focus

District/State District/State Caseworkers &Caseworkers &Outreach StaffOutreach StaffLocal Focus/Constituent ServicesLocal Focus/Constituent Services

CANCER IS UNIVERSALCANCER IS UNIVERSALSenators Jesse Helms (R-NC) & Senators Jesse Helms (R-NC) & Ted Kennedy (D-MA)Ted Kennedy (D-MA)

Senator Jim Jeffords (I-VT)Senator Jim Jeffords (I-VT)

Representatives Katherine Harris Representatives Katherine Harris (R-FL) and Rosa DeLauro (D-CT)(R-FL) and Rosa DeLauro (D-CT)

Representative Ralph Hall (R-TX)Representative Ralph Hall (R-TX)

Representative Darrell Issa (R-CA)Representative Darrell Issa (R-CA)

Speaker Dennis Hastert (R-IL)Speaker Dennis Hastert (R-IL)

Presidents Bush I & IIPresidents Bush I & II

Senate

• 100 (49-D; 49-R; 2-I)

• Two Per State – Both Senators Represent the Entire State

• Serve Six Year Terms and 1/3 of the Senate Is Up for Election Every Two Years

House

• 435 (233–D; 201–R; 1-V)

• Population Based – More Populous States Have More Representatives and Less Populated States Have Fewer Representatives

• Serve Two Year Terms and All 435 Seats Are Up for Election Every Two Years

• A Member Represents a Local District

Congress: The Basics

KEY COMMITTEESKEY COMMITTEES& CAUCUSES& CAUCUSES

Appropriations (LHHS)

Energy & Commerce (Health Subcommittee)

Ways & Means (Health Subcommittee)

House Cancer Caucus

House Nursing Caucus

• Appropriations (LHHS)

• Health, Education, Labor & Pensions

• Finance Committee

• Senate Cancer Coalition

House Senate

Who’s Really in Congress?Who’s Really in Congress?2005-20062005-2006

228 Lawyers228 Lawyers17 Medical degrees17 Medical degrees19 doctoral 19 doctoral degreesdegrees494 bachelors494 bachelorsThree nurses – Three nurses – Reps. Capps (D-Reps. Capps (D-CA), Carolyn CA), Carolyn McCarthy (D-NY), McCarthy (D-NY), and Eddie Bernice-and Eddie Bernice-Johnson (D-TX)Johnson (D-TX)

Average age House Average age House Members 56Members 56Average age Average age Senators 60 Senators 60 74 Women in the 74 Women in the HouseHouse16 Women in the 16 Women in the SenateSenate

““I’M JUST A BILL, I’M ONLY A I’M JUST A BILL, I’M ONLY A BILL…”BILL…”

Bill Introduced (#)Bill Introduced (#) Reference to CommitteeReference to Committee

Reference to SubcommitteeReference to Subcommittee Reported Out FavorablyReported Out Favorably

Full (House/Senate) Full (House/Senate) ChamberChamber

Repeat in Other ChamberRepeat in Other ChamberIf they differ, then ….If they differ, then ….

President – Enacts or Vetoes

Conference Committee

AUTHORIZATION vs. APPROPRIATING AUTHORIZATION vs. APPROPRIATING

AuthorizationAuthorization(August 2002)(August 2002)

Expands and Creates ProgramsExpands and Creates Programs

Needs To Be Reauthorized Needs To Be Reauthorized

(2008)(2008)

Nurse Reinvestment Act

Appropriations(Each Year)

Funds Programs

Sept. 30th/Oct. 1st

Fiscal Year

CAPITOL HILL:THE REAL DEALCAPITOL HILL:THE REAL DEAL

Congress Legislates by Congress Legislates by AnecdoteAnecdote

– Compelling Stories Prompt Compelling Stories Prompt ActionAction

Members Need to “Hear from Members Need to “Hear from Home”Home”

– Constituents Have An ImpactConstituents Have An Impact

Congress is Run by 20 and 30 Congress is Run by 20 and 30 Year OldsYear Olds

– Young Staffers Have Power Young Staffers Have Power and Influence, But Need Your and Influence, But Need Your ExpertiseExpertise

YOUR VOICE MATTERSYOUR VOICE MATTERSNurses Can Serve as an Advisor or Extension Nurses Can Serve as an Advisor or Extension

of Staffof Staff::

Gynecologic Cancer Education & Awareness Act Gynecologic Cancer Education & Awareness Act – ONS secured the change from “physicians” – ONS secured the change from “physicians” only, to “only, to “physicians, nurses, and key health physicians, nurses, and key health professionals” professionals”

One Letter = One LawOne Letter = One LawOne Person = Big DifferenceOne Person = Big Difference

Megan’s Law Megan’s Law MADDMADD Amber AlertAmber Alert America’s Most WantedAmerica’s Most Wanted Rosa ParksRosa Parks

Cockroach

Theory

COMMUNICATION:COMMUNICATION:TOP 10 TIPSTOP 10 TIPS

1.1. Be Clear, Brief, Polite, Be Clear, Brief, Polite, & Honest& Honest

2.2. State Up-Front What State Up-Front What You are RequestingYou are Requesting

3. Include a Personal Example

4. Give Evidence and Use Local Data (not too much) to Illustrate the Issue/Problem.

5. Discuss Positive Effects of Taking Action/Consequences of Not Taking Action

6. Repeat the Point7. Be a resource & offer to

help8. Ask Clearly for

Action/Response9. Express Your

Appreciation for Time/Attention to Your Concerns

10. Follow Up, Follow Up, Follow Up

2007 ONS Health Policy 2007 ONS Health Policy PrioritiesPriorities

Bolster the Nation’s Nursing Workforce to Bolster the Nation’s Nursing Workforce to Safeguard Public HealthSafeguard Public Health– $200 Million for federal nursing workforce programs$200 Million for federal nursing workforce programs

Advance and Ensure Access to Quality Advance and Ensure Access to Quality Comprehensive CareComprehensive Care– Increase funding for the National Institutes of Health Increase funding for the National Institutes of Health

and the Centers for Disease Control and Prevention’s and the Centers for Disease Control and Prevention’s cancer research and prevention programscancer research and prevention programs

Promote and Prioritize Tobacco CessationPromote and Prioritize Tobacco Cessation– Grant the Food and Drug Administration authority to Grant the Food and Drug Administration authority to

regulate all tobacco productsregulate all tobacco products

What Counts?What Counts?All emails, faxes, letters, calls, postcards, All emails, faxes, letters, calls, postcards, petitions, etc. are counted.petitions, etc. are counted.

Personal, handwritten letters suggest a high Personal, handwritten letters suggest a high level of priority and importance (send by fax).level of priority and importance (send by fax).

Phone calls and emails allow you to weigh-in Phone calls and emails allow you to weigh-in quickly on an urgent matter.quickly on an urgent matter.

If you establish yourself as an advisor/counselor If you establish yourself as an advisor/counselor and a key constituent, your voice will count and a key constituent, your voice will count even more!even more!

What Congressional Staff Say What Congressional Staff Say About Constituent About Constituent CommunicationsCommunications

48 percent believe the Internet and emails from 48 percent believe the Internet and emails from constituents have made lawmakers more responsive constituents have made lawmakers more responsive to their voters.to their voters.

Almost all Congressional staff “prize” individual Almost all Congressional staff “prize” individual missives written by individuals over generic messages.missives written by individuals over generic messages.

Almost all Congressional offices tally and take note of Almost all Congressional offices tally and take note of the vast majority of electronic messages they receive, the vast majority of electronic messages they receive, even if they are “mass produced.”even if they are “mass produced.”

One letter or call from a known, respected constituent One letter or call from a known, respected constituent can trump 100s of generic grassroots messages.can trump 100s of generic grassroots messages.

Advocates Come In Many Forms & Advocates Come In Many Forms & Take Action in Many WaysTake Action in Many Ways

EmailsEmails – responding to – responding to ONStat calls to action via ONStat calls to action via www.onslac.orgwww.onslac.org - click on - click on Take Action at the topTake Action at the top

Phone callsPhone calls – calling – calling offices of Members of offices of Members of Congress to weigh-in on Congress to weigh-in on issues of concern and issues of concern and speak with staffspeak with staff

LettersLetters – writing/faxing – writing/faxing personalized letters to personalized letters to Members of Congress to Members of Congress to weigh-in on issues of weigh-in on issues of prioritypriority

Advocates Come in Many Forms & Advocates Come in Many Forms & Take Action in Many WaysTake Action in Many Ways

Meetings at District/State OfficesMeetings at District/State Offices

Meetings on Capitol HillMeetings on Capitol Hill

Attendance at Town Hall MeetingsAttendance at Town Hall Meetings

Testifying at hearingsTestifying at hearings

Letters to the Editor/Op-ed PiecesLetters to the Editor/Op-ed Pieces

Establishing a close relationship with elected officials and/or their staffEstablishing a close relationship with elected officials and/or their staff – – taking the time to taking the time to become acquainted with Members of Congress and their staff helps ensure that when you become acquainted with Members of Congress and their staff helps ensure that when you email, call, write, or visit in the future that your input is valued and counted even moreemail, call, write, or visit in the future that your input is valued and counted even more

PUTTING ADVOCACYPUTTING ADVOCACYINTO ACTIONINTO ACTION

Know Who Represents YouKnow Who Represents YouRegister & VoteRegister & VoteVisit the ONS LAC – www.onslac.orgVisit the ONS LAC – www.onslac.orgSign up for ONSTAT TodaySign up for ONSTAT TodayRead Politically Speaking in ONS NewsRead Politically Speaking in ONS NewsStay Up-to-date through the CHEARStay Up-to-date through the CHEARFind Local Offices of Your Members of Congress Find Local Offices of Your Members of Congress & Visit Them& Visit ThemCall, Fax, Email Your Policy MakersCall, Fax, Email Your Policy MakersGet to Know the Congressional StaffGet to Know the Congressional StaffInvite Policymakers to Visit YouInvite Policymakers to Visit YouRespond to ONS Action AlertsRespond to ONS Action Alerts

ONS Health Policy ONS Health Policy AssociatesAssociates

DrinkerBiddleDrinkerBiddleGardnerCartonGardnerCartonWashington, DCWashington, DC

Ilisa Halpern Paul, MPPIlisa Halpern Paul, MPP

[email protected]@dbr.com, 202/230-5145, 202/230-5145

Jeremy ScottJeremy Scott

[email protected], 202/[email protected], 202/230-5197

ONS Legislative Action ONS Legislative Action CenterCenter

http://www.ons.org/lac/http://www.ons.org/lac/

OROR

http://www.onslac.org/http://www.onslac.org/

http://thomas.lo

c.gov

Recommended Health Policy WebsitesRecommended Health Policy Websites

Agency for Health Care Research and Quality – Agency for Health Care Research and Quality – www.ahcpr.govwww.ahcpr.govAmerican Academy of Nurse Practitioners Legislation and American Academy of Nurse Practitioners Legislation and PracticePractice

http://www.aanp.org/Practice+Policy+and+Legislation/Practice+and+Policy.ashttp://www.aanp.org/Practice+Policy+and+Legislation/Practice+and+Policy.aspp

American Cancer Society – Get Involved American Cancer Society – Get Involved http://www.cancer.org/docroot/GI/gi_0.asphttp://www.cancer.org/docroot/GI/gi_0.asp

American College of Nurse Practitioners Public Policy American College of Nurse Practitioners Public Policy InformationInformationwww.nurse.org/acnp/leg/index.shtmlwww.nurse.org/acnp/leg/index.shtmlAmerican Nurses Association Government Affairs American Nurses Association Government Affairs www.nursingworld.org/gova/www.nursingworld.org/gova/Cable News Network (CNN) Politics – Cable News Network (CNN) Politics – www.cnn.com/POLITICSwww.cnn.com/POLITICSCable Satellite Public Affairs Network - Cable Satellite Public Affairs Network - www.c-span.orgwww.c-span.org(US) Centers for Disease Control and Prevention – (US) Centers for Disease Control and Prevention – www.cdc.govwww.cdc.govCenters for Medicare and Medicaid Services – Centers for Medicare and Medicaid Services – www.cms.hhs.govwww.cms.hhs.gov(US) Congress – (US) Congress – http://thomas.local.gov/http://thomas.local.gov/Congress.org – Congress.org – www.congress.orgwww.congress.org

Recommended Health Policy Recommended Health Policy WebsitesWebsites

Congressional Quarterly (one of the most read periodicals on Congressional Quarterly (one of the most read periodicals on Capitol Hill) – Capitol Hill) – www.cq.comwww.cq.com(U.S.) Department of Health and Human Services – (U.S.) Department of Health and Human Services – www.dhhs.govwww.dhhs.govDemocratic National Committee – Democratic National Committee – www.democrats.orgwww.democrats.orgFederal Register – Federal Register – www.gpoacces.gov/fr/www.gpoacces.gov/fr/(US) General Accounting Office - (US) General Accounting Office - www.gao.govwww.gao.gov(US) Government Printing Office – (US) Government Printing Office – www.access.gpo.govwww.access.gpo.govHealth Resources and Services Administration – Health Resources and Services Administration – www.hrsa.govwww.hrsa.gov(US) House of Representatives – (US) House of Representatives – www.house.govwww.house.govKaiser Family Foundation – Kaiser Family Foundation – www.kff.orgwww.kff.orgLeague of Women Voters – League of Women Voters – http://www.lwv.org/http://www.lwv.org/National Association of Counties – National Association of Counties – www.naco.orgwww.naco.orgNational Association of Pediatric Nurse Practitioners - National Association of Pediatric Nurse Practitioners - www.napnap.orgwww.napnap.org (click on Advocacy) (click on Advocacy)National Cancer Institute – National Cancer Institute – www.nci.nih.gov/www.nci.nih.gov/National Conference of State Legislatures – National Conference of State Legislatures – www.ncsl.orgwww.ncsl.orgNational Council of State Boards of Nursing – National Council of State Boards of Nursing – http://www.ncsbn.orghttp://www.ncsbn.org

Recommended Health Policy Recommended Health Policy WebsitesWebsites

National Governors Association – www.nga.orgNational Governors Association – www.nga.orgNational Institutes of Health – www.nih.govNational Institutes of Health – www.nih.govNational Journal (one of the most read periodicals on Capitol National Journal (one of the most read periodicals on Capitol Hill)Hill)www.nationaljournal.com www.nationaljournal.com Oncology Nursing Society Legislative Action Center – Oncology Nursing Society Legislative Action Center – www.ons.org/lacwww.ons.org/lacOncology Nursing Society On-Line Advocacy Course - Oncology Nursing Society On-Line Advocacy Course - http://onsopcontent.ons.org/Meetings/HealthPolicy/home.htmhttp://onsopcontent.ons.org/Meetings/HealthPolicy/home.htmllProject Vote Smart – www.vote-smart.org/Project Vote Smart – www.vote-smart.org/Republican National Committee – www.rnc.orgRepublican National Committee – www.rnc.orgRoll Call (one of the most read newspapers on Capitol Hill) Roll Call (one of the most read newspapers on Capitol Hill) www.rollcall.comwww.rollcall.comRoster of National Nurse Practitioner and Nursing Roster of National Nurse Practitioner and Nursing Organizations www.nurse.org/acnp/resources/index.shtmlOrganizations www.nurse.org/acnp/resources/index.shtmlU.S. Senate – www.senate.govU.S. Senate – www.senate.govU.S. Conference of Mayors – U.S. Conference of Mayors – www.usmayors.org/uscm/home.aspwww.usmayors.org/uscm/home.aspWhite House – www.whitehouse.govWhite House – www.whitehouse.gov