1. Advocating for your Health
Center in Today‟s Political
Climate
Douglas M. Paterson MPA
Director of State Policy
Michigan Primary Care Association
May 22, 2012

2. Two types of organizations
◦ Those who allow others to determine the
environment in which they operate
◦ Those that shape and influence the
environment in which they operate
 Every board must decide which type
they will be.

3. Build A Culture of Advocacy
 Change your culture to
one where effective
advocacy is an
essential element daily
work.
 Develop and
recognize grassroots  The Essential Step:
advocacy Elevate advocacy to
effectiveness the the level of an
same way you do organizational priority
other critical skills for – for Board and Staff.
health center staff and
boards.

4. Advocacy versus Lobbying
 Advocacy – education to make policy
makers more aware what you do and
how policy influences your
organization.
 Lobbying – asking legislators to take a
position on specific legislation.

5. What is Grassroots Advocacy?
Grassroots advocacy: the
active support of a cause,
issue or policy that gets its
strength from the ground up
rather than from the top down.
Democracy is dependent upon
an informed and involved
electorate. It is essential that
citizens have input in how
their government develops
policy and spends funds.

6.  All your advocacy efforts should have two goals:
 Building a relationship with your elected officials
and/or their staff which:
 Assures you are known to the policy maker
 You are viewed as a credible source of information on health center
issues
 Your input is valued and sought
 Your calls get returned
 Building 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.
6

7. 1. Advocacy 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 Needs to be done Face to Face
Plan to get your local, state and federal officials (and
their staff) to your Center on a regular basis
3. Advocacy Needs Numbers
If 100 emails and faxes are good, a thousand is
better!
7

8. 4. Advocacy Needs a Megaphone
Learn how to use the media
5.Advocacy Needs Friends
Look for ways to reach out to other organizations in your
community on a regular basis
6. Advocacy Needs Votes
Empower your health center by making sure your patients
and staff are registered to vote and that they vote!
7. Advocacy takes commitment
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.
8

9. Things that Work
 Provide board members,  Publicly recognize those
staff and patients information who sign up for our
on a regular basis about advocacy network and who
what is happening in take effective action.
Washington and the state
 Establish an ongoing
capital and how it could
schedule of hosting and
affect their center.
meeting with local, state,
 Make advocacy a standing and federal elected officials
item on the agenda at every at the health center.
board and staff meeting.
 Find ways to involve patients
in as many advocacy
activities as possible.

10. 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.

11. Two types of Lobbying
 Direct Lobbying – any attempt to influence any
legislation through communication with a
legislator, an employee of a legislative body or
government official addressing SPECIFIC
legislation and reflecting views on such
legislation
 Grassroots Lobbying – any attempt to influence
legislation through an attempt to affect the
opinions of the general public related to
specific legislation.

12. Lobbying - preparation
 Know your issue – research and verify facts
and background
 Who has interest in the legislation
 Why should legislator support or oppose
 Why is it important to your health center
 What facts and merit can you produce to
make your case.

13. Communicating with your
legislators – Five questions
Who am I?
What is my issue?
Why do I care?
Why should the legislator care?
What should legislator do?
(Do NOT hesitate to ask the
legislator if you can count on
his/her support)

14. Letters
 Do not send form letters
 Be personal and unique
 Address legislator by name
 Use a subject title above name simply
stating the purpose. (E.G. SB 349)
 Mention you live in district
 State your opinion and request
response
 Be brief and clear. Keep to one page

15. Email
 Be short
 Use same care as letter
 Include your first and last name, your
mailing address, phone number and
organization
 Request a response

16. Phone Calls
 Before you call, take a moment to gather your thoughts.
Write a mini-outline of what you plan to say.
 Identify yourself by stating your name and that you are a
constituent
 Ask if the legislator is available to discuss (describe issue)
- you will likely be directed to a staff person.
 Briefly educate the legislator or staff of your agency
 State your specific issue
 Keep message simple – less than four minutes
 Politely ask staff how the message will be conveyed
 ASK for a commitment
 Ask for any response in writing

17. Scheduling a Visit
 Call the legislators office and ask for
scheduler
 Tell scheduler you are a constituent
and would like an appointment to
discuss (issue)

18. Meeting with Legislators
 Do your homework
 Create a packet to leave (2 copies)
 Bring business cards and contact info
 Call day ahead to confirm
 Be on time
 Always introduce yourself
 Don‟t make up answers to questions – if you don‟t know,
tell them you will get back with them. Be sure to follow
up.
 Present both sides of an issue in a fair and honest
manner
 Identify others who support your position
 Limit the number of people you bring
 NEVER INTERUPT a legislator
 Don‟t offer opinions outside your direct concern
 ALWAYS TELL THE TRUTH – credibility is your capital.
 Ask for a commitment
 Ask what you can do to help the legislator
 Don‟t hesitate to talk to staffers – they can be good
advocates.

19.  Go to www.NACHC.com and
register as a health center
advocate.
 Advocacy/Voter Registration
 Sign Up
 Visit the NACHC Grassroots
action center
19

20.  Go to www.mpca.net and
register as a health center
advocate.
 Policy and Advocacy
 Advocacy Center
 Stay informed
 Sign Up
 Visit the MPCA Action center
20

21. Summary
 It‟s about relationships!!!
 It takes commitment
 It takes effort
 It takes involvement
 It takes moxie

22. Friends of Michigan‟s
Community Health Centers
 An independent political action committee
representing community health centers in
Michigan
 Collective advocacy and lobbying for high
quality, culturally competent,
comprehensive health care for all citizens
 Non-partisan
 Dependent on individual donations from
people who believe in this cause.
 Goal - $500 per member center

23. National Health Center Week
August 5th thru August 11th.
 Invite Congressional leaders, State
and Local Elected Officials, Key
Leaders
 Events
 Submit Op-Ed articles, Letters to the
Editor to local press outlets

24. Questions or assistance
Doug Paterson
Michigan Primary Care Assoc.
7215 Westshire Dr.
Office – (517) 827-0463
Cell – (517)614-0705
dpaterson@mpca.net

26. Community Health Vote 2012
Non Partisan Voter Engagement
at Health Centers
March, 2012
Presented by
Marc Wetherhorn
National Advocacy Director

27. "In reality, there is no such thing as not
voting: you either vote by voting, or you vote
by staying home and tacitly doubling the
value of some Diehard's vote.“
– Davis Foster Wallace

28. National Association of Community Health Centers
Community Health Center Voter Engagement

29. Why Health Centers
Gap in Voter Turnout by Income
in recent Presidential Elections
80%
77%
75% 76%
72%
70%
65%
60%
59% 59%
55% 55%
50%
2000 2004 2008
Below $50k $50k and above

30. Why Health Centers
Gap in Voter Turnout by Ethnicity
in Presidential Elections 1980 - 2008
0.75
0.65
0.55
0.45
0.35
1980 1984 1988 1992 1996 2000 2004 2008
White Black Hispanic Asian

31. Why Health Centers
• Elections matter to the future of health centers and
the health of our patients
• The populations least likely to vote are OUR patients
• 2/3‟s of our patients (over 12 million) are voting age
• Health centers have a trusted relationship with their
patients
• Having more of our patients as voters dramatically
leverages our advocacy power
• Because WE CAN make an impact

32. Why Health Centers
4 Reasons People Vote
 Have a Reason to Vote
 Have Personal contact
from family, friend, nonprofit
 It’s Easy and Accessible
 A habit learned from
family and community

33. Voter Engagement –
Not Just Voter Registration
1. Actively encourage clients and staff to register to vote
2. Communicate with all, or as many clients as possible, in a
non-partisan way about the importance of voting for their
health and their health center
3. Make voting information as visible as possible throughout
the centers
4. Make non-partisan voter registration an integral part of
National Health Center Week activities
5. Participate in National Voter Registration Day – 9/25/12
6. Conduct a national non-partisan get out the vote effort
leading up to and on election day
7. Track our results in increasing voter turnout among our
clients

34. THE RULE to Remember
May Not Support
or Oppose a
Candidate for
Public Office

35. The Rules: Dos and Don’ts
DO DON’T
Voter Registration • Endorse a candidate for
Voter Education office
Distribute Sample Ballots, Guides • Give resources to
candidates
Co-sponsor Candidate Forums
• Rate candidates on
Educate the Candidates your issue
Remind People to Vote • Tell people how to vote
Help on Election Day:
Recruit Poll Workers
Support or Oppose Ballot Questions

36. How Do We Do It - Registration
Work with legal and voting experts to establish legal
guidelines and tools to ensure compliance with federal and
state laws
Establish Community Health Vote kiosks within health centers
As resources allow, provide computers and printers for self registration
either directly online (where possible) or via printed forms. In other places
make state or federal forms available at kiosks.
Integrate or emphasize registration in public assistance
enrollment at sites where this is already being done or could
be done
Identify and work with local partners to assist in the effort

37. How Do We Do It - Registration
Integrate voter registration into your Health Center’s
ongoing activities
•Designate a staff person at each site to serve as coordinator of your
Health Center‟s voter registration activities.
•Make sure to contact your county registrar and learn any local
requirements for registration or registering voters
•Ask every patient at intake if he/she would like to register to vote or
update their registration; provide a voter registration application, a
“qualification form,” and a follow up enrollment card;
•Ask staff, volunteers, and board members if they would like to register to
vote during meetings;
•Register voters at community events, especially
National Health Center Week - August 5-11, 2012
National Voter Registration Day – September 25, 2012

38. How Do We Do It - Registration
1. Put up posters around your health center, not just in the waiting room to let
patients know that voter registration forms are available.
2. Register AND Educate: Give everyone an option to get more information
and to sign up as an advocate.
3. Assure completed forms get submitted - provide envelopes or boxes for
voter registration and advocacy forms to be dropped into upon completion.
Know how long you have to turn in completed registration forms to your
County registrar or Secretary of State after they are filled out. Have a staff
member designated to turn in all completed forms each week, OR partner
with a local community volunteer to pick up your health center’s voter
registration forms.
5. BEFORE YOU TURN IN VOTER REGISTRATION FORMS: Track the
number of voter registration forms completed at your health center and
capture information for those who want reminders and information

39. How Do We Do It - Registration
“The NVRA has a provision to designate offices that provide
„public assistance‟ as voter registration agencies. Public
assistance agencies include any site where an individual
may apply or receive an application for Medicaid, such as
FQHCs. Under this law, FQHCs with State, city, or county
employees as outstationed Medicaid eligibility workers are
considered public assistance offices and must provide voter
registration services. The FQHCs that use
non-governmental employees as outstationed Medicaid
eligibility workers (e.g., clinic staff, volunteers) may provide
voter registration services.”
-BPHC Program Assistance Letter 2000-18

40. How Do We Do It - Registration
Integrate or emphasize registration in public assistance
enrollment at sites where this is being done
• Train or educate enrollment staff on the importance of
offering registration as part of this process and how to assist
registrants
• Provide a separate opt-in form or mechanism to allow
registrants to sign up as health center advocates and/or to
get ongoing voting information and reminders

41. How Do We Do it - Education
Encourage registrants to become advocates and/or to get
ongoing voting information and reminders
Assemble registrant contact information in a database
Periodic email and text updates and information about voting
locations times, early voting, etc.
Reminders about registration and voting in some patient
communications
Periodic “how-to” vote sessions, including early voting and
voting hotlines to assist clients in voting
In states with new voter laws or ID requirements, provide
information about the changes and how to comply

42. How Do We Do It – Education & GOTV
• Capture registrant contact information
Use Computer Interface or Manual Tracking forms
Enter and/or assemble registrant contact information in a
database
• Send periodic email and text updates and information
about voting locations, times, etc.
• Provide voter information materials and signage
throughout the health center
• Include reminders about registration and voting in some
patient communications
• Periodic “how-to” vote sessions, on the mechanics of
voting, including early and absentee voting and voting
hotlines to assist clients in voting

43. National Resources
Fair Elections Legal Network
Nonprofit Vote
TurboVote
State Voices
National Council of La Raza

44. Elements of Success
• Organizational Commitment – Board and
staff understand the importance
• Individual Champions – someone
responsible who WANTS to make it
work
• A plan for implementation
• Support from NACHC, PCAs & Partners

45. Important Dates
• Election Day: November 6, 2012
• Early Voting periods: vary by state
• Registration closing dates: vary by state
• National Voter Registration Day: September 25, 2012
• National Health Center Week: August 5-11, 2012
• Your Health – Your Voice – Your Vote Kickoff:
NACHC P&I, March 21, 2012

46. Nobody made a greater mistake than
he who did nothing because he
could do only a little.
– Edmund Burke

47. The Power of Large Numbers
If every health center site registered 1
new voter every business day from
May 1 to October 6, we would register
nearly 1,000,000 new voters!

48. Program Assistance Letter 2000-18
For More Information
Marc Wetherhorn
mwetherhorn@nachc.com
540-942-3862
www.CHCVote.org