Sustained Grassroots Activity
A Marathon, Not a Sprint.
By Jerome connolly, Pt, cae
August 8, 2014
On a picturesque Saturday in Portland, Oregon, on the last day of May, private practice physical therapists from Washington and Oregon showed up at West Café for an event honoring Oregon Senator Ron Wyden, the current chairman of the powerful Senate Finance Committee. The event was the brainchild of PPS member Clem Eischen and Diana Godwin, both of whom have known the senator for many years.
Over 35 physical therapists in attendance had the opportunity to interact and converse with the chairman for nearly 90 minutes. The topics of discussion included trends in health care delivery models and issues specifically impacting PPS members.
In both his preliminary remarks and his response to questions, Senator Wyden displayed his passion for health care and his penchant for detail. On Medicare payment, Wyden once again committed to repeal and replace the flawed sustainable growth rate (SGR) formula used to calculate our Medicare payments. The chairman also emphasized his support for permanently repealing the arbitrary therapy caps and moving toward an alternative payment method.
He addressed our locum tenens issue in detail, showing his understanding of the problem and his support for adding physical therapists to the list of providers permitted to bring in a qualified licensed substitute therapist when the owner must be away for a short leave. The change would allow Medicare patients to continue their care uninterrupted and the practice to bill for this treatment.
He professed his strong belief that Medicare patients should be allowed to seek care from any qualified provider of their choosing, and he voiced his favor for ending abuses associated with physician self-referral, as long as patient access is not sacrificed.
Senator Wyden’s rise to the chairmanship occurred in February of this year when then chairman Max Baucus (D-MT) was nominated by President Obama to become Ambassador to China. After confirmation by his Senate colleagues, Baucus was on his way to Beijing and Wyden took the gavel of what is arguably the most influential committee in the upper chamber.
The successful Portland event, an example of grassroots-in-action, provides many lessons for PPS members. Perhaps the most notable lesson falls into the category “you just never know.”
Clem Eischen met Wyden when the policymaker was still an Oregon congressman in the House of Representatives, and Clem invited him to speak to a group of local physical therapists at his clinic. Little did Clem, or anyone else, know that the future would find the young Wyden in the United States Senate on the Finance Committee, and ultimately, in the chairman’s seat.
Diana Godwin has owned her own law practice since 1979 and has been representing private practice physical therapists in Oregon for over 25 years and in Washington for the past 6 years. She is the lawyer and executive director for two statewide private practice organizations— Oregon Physical Therapists in Independent Practice (165 members) and the 170-member Private Practice Special Interest Group (PPSIG) of the Physical Therapy Association of Washington.
Diana became acquainted with Ron Wyden when they attended the University of Oregon Law School together in the mid-1970s. This, of course, was well before Wyden became active in organizing and working for the “grey panthers.”
As we all know by now, one of the most important aspects of grassroots political activity is the development of a relationship with the target legislator. While Clem and Diana had the fortuitous opportunity to meet Wyden long ago, and while some of the developments were happenstance, the fact that they have nurtured and maintained the relationship is a testament to their political acumen and commitment to advancing the profession through policymaking. This exemplifies effective and sustained political involvement.
We never know where our friends, acquaintances, and colleagues are going to end up. And not all of us will have the fortune to have a history with the next chairman of a strategic congressional committee with jurisdiction over Medicare. However, we all do have the capability of exercising our initiative to establish a strong, ongoing, and meaningful relationship with key legislators.
This year, PPS embarked on building an effective Key Contact program with the intent of establishing and training PPS members as liaisons to federal lawmakers who, by their position or assignment, have the potential to influence the federal health care policy that affects us and our patients.
This Key Contact program is essential for successful advocacy, and with the assistance of members of the PPS Board of Directors and its Government Affairs Committee, PPS Key Contacts now number in the low one hundreds (111 at the time I am writing this column). This is an outstanding response, and PPS members who have agreed to participate are to be commended.
As we have proceeded with the Key Contact recruitment process, the need for training these volunteers in methods to be effective and successful has been identified. Consequently, the Board has approved a workshop for PPS Key Contacts that will be held in Washington in the fall of this year.
Of course, this event will provide valuable lobbying tips. But it should be said that the most important role an effective Key Contact can play is not visiting the target legislator in Washington, but establishing an ongoing relationship with the policymaker in your own hometown. Legendary Speaker of the House “Tip” O’Neill is known for coining the profound phrase “All politics is local.” This is an adage all of us—PPS Key Contacts and members at large—should live by if we expect to be effective in the legislative arena. Put simply, O’Neill suggests that what happens in the grassroots arena is most important to every politician. Being involved and recognized in our own communities, as health professionals, business owners, responsible citizens, is the key to establishing a valued relationship with our legislators. In addition, of course, we must reach out to the policymaker, provide information, viewpoints, and perhaps even support, to become part of the legislator’s circle of reference. As we all know, successful relationships are not built on a one-time effort. They must be nurtured and sustained. Trust must be accomplished and rapport established much in the same way we develop an effective partnership with each of our patients.
Does being an effective Key Contact require significant monetary contributions to the elected official? Is it necessary to attend or hold successful events for the politician as Diana and Clem did for Chairman Wyden? The answer to both questions is not necessarily.
It is true that money is considered the “mother’s milk” of politics, but a relationship based on trust, confidence, and consistency is highly valued by every legislator. There are numerous ways other than financial support that are helpful in building a strategic relationship, including hosting the legislator in your clinic for a site visit as Clem did years ago. All of these methods and tactics will be explored and shared in the upcoming Key Contact training program.
I congratulate Clem and Diana and every member who attended the brunch with Senator Wyden on an impressive gathering. I thank and commend the nearly 300 PPS members from across the country who recognized the value and contributed to the financial success of this event. The dialogue that was accomplished, the bidirectional exchange of ideas between the attendees and the chairman, and the fact that over 35 private practice physical therapists gave up a sunny Saturday morning to spend time with Ron Wyden is something he will not forget.
Keep in mind that relationships are not flings or a one-time stand. We all need to continue to reach out to the chairman and to our own legislators to let them know how they can shape policy that will better serve private practice physical therapists and our patients. You know Clem and Diana are not going to stop now. Let’s follow their example and engage in the PPS advocacy effort through our grassroots channels, maybe even becoming a PPS Key Contact. You never know, your legislator may grow up to be chairman of a powerful committee. Remember, effective advocacy is a marathon, not a sprint.
Jerome Connolly, PT, CAE, is a registered federal lobbyist whose firm Connolly Strategies & Initiatives has been retained by PPS. A physical therapist by training, he is a former private practitioner who throughout his career has served in leadership roles of PPS and APTA. Connolly also served as APTA’s Senior Vice President for Health Policy from 1995 – 2001.
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