Advocacy Strategies

How to engage in effective healthcare advocacy?  Many regional neuropsychological organizations have developed health care reform committees or have their advocacy committees working on healthcare reform issues.  Others would would like to form a healthcare advocacy committee, but may not have a general advocacy committee up and running in their organization.  We have compiled strategies for forming and maintaining an effective healthcare advocacy committee, and engaging in effective healthcare advocacy.  These strategies also apply broadly to many other advocacy activities Psychologists might engage in as well.  

360 Degree Advocacy Model

Legislative Testimony

Psychologists and neuropsychologists are in a unique position to contribute to the public debate over healthcare as well as important social issues of our day.  We bring our ability to distill and interpret scientific data, our understanding of human motivations and experience, and our ability to build coalitions and connections within larger systems. As we do, policy makers, legislators, and the public’s understanding of who we are as professionals and what we bring to our roles within healthcare increases. 

Dr. Wills recently testified at the Minnesota State House on a bill legalizing same sex marriage.  Her testimony demonstrates the best of what Psychology can bring to a legislative hearing:

Whether psychologists are testifying about a specific piece of healthcare legislation or about issues affecting the broader culture, Dr. Will’s testimony is an excellent model.

Getting Neuropsychology/ Psychology in the news

Helping legislators, regulators, and corporate decision makers understand the value that neuropsychologists and psychologists bring to the healthcare table lays the groundwork for effective advocacy. Rather than always showing up with "an ask," we need to show up contributing to the larger discussion.  Getting neuropsychologists and psychologists in the news, commenting on events, supplying data, and offering advice: "giving psychology away" is excellent advocacy strategy. 

Help a reporter out (HARO)

"Help a reporter out" or HARO is a great way to get neuropsychologists in the news.  This is a free listserv that sends out queries from reporters all over the country.  The reporters are asking experts in every field to "help a reporter out" with info/ advice/ etc.  t takes a moment to open the email every morning, and scan to see if any reporter needs information from a neuropsychologist or psychologist.  You then email the reporter, and see if you get a bite.  

Assign a member of your advocacy committee to monitor HARO and respond to reporters as opportunities to speak out about what we offer as a profession emerge.

Sample HARO query

5) Summary: Exploring how mental health is handled by insurance companies, physicians and healthcare facilities

Name: Valerie Jones Insurance Quotes

Category: Biotech and Healthcare

Email: (email of reporter was here)

Media Outlet: Insurance Quotes

Deadline: 11:00 AM CST - 20 March

Query: 

Looking to speak with mental health counselors about different
disorders, ranging from mild/moderate depression to more severe
disorders such as schizophrenia and bipolar disorder and some of
the biggest obstacles/limitations on getting coverage.

Requirements: 

Must have experience working with mental health patients and be
knowledgeable of insurance policies and laws.

Advocacy Checklist

General principals

• Focus on Patients. Effective advocacy focuses on preserving and broadening access to neuropsychology services for patients. The goal of these efforts is to maintain and expand access to medically necessary healthcare. This is important, because advocacy efforts based on preserving neuropsychologists’ income, while important, is not the primary concern to policy makers. The most critical outcome of limited coverage -- or no coverage -- of evaluations is reduction in patient access to services, either through denials of coverage or attrition within the profession.

• Work with existing organizations.Contact and work with your state psychological and neuropsychological organizations so that efforts are coordinated and not duplicated, overlapping, or counterproductive. Partnership between state psychological associations and state/ regional neuropsychological associations in healthcare advocacy is ideal.

In Massachusetts, Michelle Imber, Ph.D., ABPP-CN has written an outstanding article about the successful, multi organizational effort to pass transparency legislation protecting patients from for-profit medical criteria sets that limited neuropsychological assessment coverage.  This is a great example of "360 degree advocacy" pulling in regional, state, and national neuropsychological organizations.  Click here to read. 

• Replicate success. Watch what other states/ regions are doing, and replicate success. Whenever possible, pick up the phone and call colleagues; reach out.

• Build coalitions with other mental health/behavioral providers and their professional organizations, as well as patient centered advocacy groups.

• Talk with policy makers about what we do. Very few policy makers know what neuropsychologists do. Even if you do not have an “ask,” spend time talking about why neuropsychological assessment and intervention improves quality and saves healthcare dollars.

• Activate local leaders to get a national message across. Many state regulators and legislators feel most comfortable when the message is coming from in-state leadership. Messages from "out of state folks" may leave the impression that the issue or perspectives are not relevant to local concerns.

• Don’t wait for a reasonable grasp of healthcare reform to jump in. Literally no one knows how this is going to turn out, or what it will look like a few years from now. Don’t be discouraged if this seems overwhelming; once you get started, information, experience, and support from others buoys your efforts.

• Form a Healthcare Advocacy Committee within your state or regional neuropsychological organization, if one does not yet exist. See below for some helpful organizing goals.

Six goals for Healthcare Advocacy Committees

• Identify key public and private sector committees that are creating healthcare regulations in your state and work to place a neuropsychologist on those committees.

• Identify and build relationships with state legislators who serve on healthcare-related and behavioral healthcare-related committees. Educate your members regarding which districts those legislators represent, so members know if their representative or senator is especially active on these issues.

• Assign people in your committee to track development and progress of healthcare-related legislation, regulations, and hearings.

• Assign people in your organization to track and report pilot programs and other developments for new service delivery and payment models

• Educate your members through electronic notices, information on your website (link to IOPC web toolkit) and CE programs.

Other Pointers

• Get to know and learn from people who are working in integrated care and ACO systems in your state/ region.

• Encourage members to be empowered constituents: get to know their state legislators. Demystify working with legislators: State representatives, senators, delegates or assembly members typically enjoy getting to know their constituents; value hearing from constituents; and welcome knowing who in their districts can be resources for them regarding issues.

• Provide legislative/action alerts when mass action is needed so that your organization’s members, as constituents, can educate their state legislators and other elected officials when bills are being written and considered.

• Work with professional lobbyists if your organization's charter allows (for example, if not restricted by non-profit status)