Advocacy Day—in Washington and "on message"

AORN Journal, Nov, 2004 by Burke Beu

More than 100 AORN members and AORN Headquarters staff members attended the Public Policy Conference and Advocacy Day in Washington, DC, on Sept 20 and 21, 2004. The event featured presentations by spokespeople from the two major political parties' presidential campaigns and provided an opportunity for participants to go to Capitol Hill for face-to-face meetings with members of Congress and their legislative aides. This article provides a summary of the activities of those two days.

The event opened with greetings from Armando Riera, RN, BSN, CNOR, chair of the AORN Legislative Committee, and AORN President Bill Duffy, RN, BSN, MJ, CNOR. President Duffy reminded attendees that public policy advocacy and legislative activity are important ways of "celebrating our value," which is the theme of his presidency.

Burke Beu, AORN federal legislative analyst, reviewed state public affairs and AORN's legislative priorities, which are represented by the acronym KEYS.

* Keep the RN in the OR.

* Enforce and protect scope of practice.

* Yes to collaboration.

* State and federal legislation for RNFA reimbursement and emerging issues.

Beu stressed the need to convey a simple, concise, and direct message in meetings with members of Congress. Three key points were emphasized:

* support House Resolution 682,

* support Medicare reimbursement for RNs who first-assist in surgery, and

* support the Nurse Reinvestment Act. These points were discussed in detail in the cover letter of the Advocacy Day informational packet, which is reprinted here.

Support House Resolution 682. This resolution was introduced by Rep Mark Udall [D-Colo] for public awareness of the goals and ideas of National "Time Out" Day, in order to promote the adoption of the Joint Commission on Accreditation of Healthcare Organization's universal protocol for preventing errors in the operating room. The first National "Time Out" Day was June 23, 2004 .... We urge you to support this resolution or consider sponsoring a Senate companion.

Support Medicare reimbursement for RNs who first-assist in surgery. AORN has lobbied Congress for many years for legislation providing Medicare reimbursement to [RNs] who perform the first assistant role during a surgical procedure. Currently, physicians who first-assist are reimbursed by Medicare at 15% of the surgeon's fee. Eligible non-physician providers are reimbursed at a rate of 13.6%. Qualified RNs should be included on the list of eligible non-physician providers. The Medicare Modernization Act of 2003 mandated a study of this topic by the Medicare Payment Advisory Commission [MedPAC]. MedPAC received an initial report earlier this month and will be making a final recommendation soon. A report to Congress is due in January 2005. AORN has provided background information to MedPAC as well as public testimony at MedPAC meetings, and we are working with the commissioners to achieve a favorable recommendation. MedPAC considers many proposals and new models for the future of Medicare. Whatever approach is taken, RNs are at least as qualified as other reimbursed providers and should be equally reimbursed. We ask that you stay alert to this issue, as we offer news and follow-up.

Support the Nurse Reinvestment Act. As a member of the Nursing Organizations Alliance, AORN stands united with the nursing community in support of $205 million in [fiscal year] 2005 funding for tlw vitally important programs authorized by this legislation. (1)

GRASSROOTS OUTREACH

Christopher Kush, MPP, president of Soapbox Consulting, Washington, DC, the agency contracted by AORN to schedule congressional appointments during Advocacy Day and provide a presentation on successful grassroots outreach, urged participants to stay "on message" by using both personal and factual accounts when communicating with elected officials.

With role-play segments and interactive exercises, he highlighted the effectiveness of five approaches:

* real-life stories that personalize an issue,

* general local statistics,

* examples of government money spent in the constituent's home district,

* the visibility and momentum of one's organization in the community, and

* specific action that would bring satisfaction to the constituent.

Kush used a fishing analogy to describe meetings with legislators as having a hook (ie, friendly introductions), a line (ie, discussing the message points), and a sinker (ie, asking for what is wanted). He cautioned attendees against several common but potentially harmful mistakes, including the following.

* Do not go "off message."

* Do not be late for or "blow off" a meeting.

* Do not dress down.

* Do not be sweet-talked into being too comfortable.

* Do not joke about security measures at the Capitol.

* Do not engage in excessive praise or scorn.

* Do not discuss numerous bills or unrelated topics.

* Do not forget to follow up.

Follow-up should include a thank-you call and an offer to be an expert resource to the official for issues concerning perioperative nursing. Kush also said that everyone should be alert to how an official responds--and stop talking when he or she agrees.