National Health and the
Impact of Nurse Advocacy
Government and Community Relations
Fall 2016
What I Plan to Share
• Advocacy 101
• Cleveland Clinic
• Fire Up Discussion
Lobbying and Advocacy
• Lobby: “an organized group of people
who work together to influence
government decisions that relate to a
particular industry, issue.”
• Advocacy: ‘the act or process of
supporting a cause or proposal.”
Nurses again top Gallup's list of 'most
trusted' professionals
1. Nurses
2. Medical doctors
3. Pharmacists
4. Police officers
5. Clergy
6. Bankers
7. Lawyers
8. Business
9. Advertising
10. Car sales
11. Politicians
Nurses take the top spot again
According to the survey, 80% of
respondents rated nurses as
having very high "honesty and
ethical standards." About 65%
saying the same for medical
doctors and pharmacists.
Lobbying/Advocacy 101
• Establish a relationship with elected
officials AND staff
• Share your story
• Stay in touch
Start with Policy…
and then Overlay Politics
• Decision-making never takes place in a
vacuum
- Public policy decision makers (counsels,
mayors, state officials) apply individual
principals…
(as they see an issue through a lens
colored by “politics”)
Government and Community Relations
Government
Policy
Community
Regional
2021 Goal: Establish the Cleveland Clinic as the
undisputed leader in transforming the health and
wellness of the communities in which we work.
Advocacy Principles
1.
2.
3.
4.
5.
6.
7.
8.
Be truthful
Make friends before you need them
Define what success looks like
Pick the right Champion
Help your Champion help you
Stay nimble
Be tenacious – never give up
ALWAYS take the high road
Truthful
Friends
Health + Faith Cooperative
Build trusting and collaborative partnerships
with the faith community.
The Seven Dimensions
of Wellness
What is Success?
1. Make something happen
2. Modify something
3. Clarify something
4. Create awareness about something
5. Stop something
Bad guys doing the right thing?
Good guys doing the wrong thing?
Stories Motivate
Personal Responsibility
Government
Community
Gap
•
•
•
•
Infant Mortality
Chronic Disease
Addiction
Obesity
Population
Health
The Story of Langston Hughes
Community Center
Advocacy Principles
1.
2.
3.
4.
5.
6.
7.
8.
Be truthful
Make friends before you need them
Define what success looks like
Pick the right Champion
Help your Champion help you
Stay nimble
Be tenacious – never give up
ALWAYS take the high road
MEDICAID:
THE PAC-MAN OF THE STATE BUDGET
Total State and Federal GRF Expenditures
1975
9%
12%
Education
Human Ser
54%
25%
Medicaid
Other
OHA System CEO Meeting │ Top
January 8, 2
MEDICAID:
THE PAC-MAN OF THE STATE BUDGET
Total State and Federal GRF Expenditures
1985
15%
Education
44%
19%
Human Ser
Medicaid
Other
22%
OHA System CEO Meeting │ Top
January 8, 2
MEDICAID:
THE PAC-MAN OF THE STATE BUDGET
Total State and Federal GRF Expenditures
1995
15%
38%
Education
Human Ser
Medicaid
30%
Other
17%
OHA System CEO Meeting │ Top
January 8, 2
MEDICAID:
THE PAC-MAN OF THE STATE BUDGET
Total State and Federal GRF Expenditures
2005
15%
39%
Education
Human Ser
Medicaid
Other
38%
8%
OHA System CEO Meeting │ Top
January 8, 2
MEDICAID:
THE PAC-MAN OF THE STATE BUDGET
Total State and Federal GRF Expenditures
2014
12%
36%
Education
Human Ser
Medicaid
Other
45%
7%
OHA System CEO Meeting │ Top
January 8, 2
Total Federal Expenditures
2015
17%
Retirement
Benefits
Health Care
19%
58%
Welfare
Other
6%
OHA System CEO Meeting │ Top
January 8, 2
Changes in Reimbursement
Follow the Money
February
Administration
Budget
March - April
Budget
Hearings
April/May
Budget
Adopted
Define entitlement issues
Submit appropriations requests
Track reauthorizations
May – Sept
Appropriations
and
Reconciliation
October 1
Appropriations
Passed or CR
Fall Priorities: Lame Duck
• Medical Orders for Life Sustaining Treatment
(MOLST)
• Advanced Practice Registered Nurses (APRN) Bill
• Autism Bill
• Community Health Needs Assessment Language
Fix
• Prior Authorization Fix
• Health Care Transparency Language Fix
• Infant Mortality Commission Recommendations
• State Trauma System
State of Play in DC
• Title VIII Funding
• APRNs/VA
• Hospital Payment Reform
• Healthcare Innovations
• Mental Health Reform
• Opiate Addiction Crisis
Hospital Outpatient Facilities
• “Site-neutral” payment
- Section 603, Bipartisan
Budget Act of 2015
- AMA supports
- AHA opposes
• Questions:
- Appropriate settings of care?
- Level of payment?
- Impact of consolidation?
In Summary
• Stick with your principles
• Policy makers are fiscal stewards:
everything boils down to money
• Engage
One of the penalties for refusing to
participate in politics is that you
end up being governed by your
inferiors.
Plato