All Politics Is Local—Why Long-Term and Post-Acute Care Leaders Should Participate in Grassroots Advocacy

By Bill Charnetski

The late House Speaker Tip O’Neill used to say, “All politics is local,” to remind his fellow lawmakers in Washington, DC, that everything they do has an impact back home and voters are motivated by whatever impacts them most.

Lawmakers in Washington and your state capital will make decisions about your business, whether they hear from you or not. If it helps you to speak up, don’t think of it as lobbying. Think of it as telling the story of your passion and industry to busy, powerful strangers who can make your job easier or harder through their decisions. It’s a conversation you can’t afford not to have.

Lobbying is Not a Dirty Word

Like politics, “lobbying” can have an unsavory connotation. It can conjure up images of backrooms and favor-swapping. However, the majority of lobbying doesn’t happen on K Street in DC. Lobbying in its purest form is simply asking elected representatives and agency administrators to act in a certain way. The resident speaking out at the end of a city council meeting is lobbying. So is the class of fifth graders writing a letter asking for the blue jay to be named the official state bird.

You can become a grassroots lobbyist for your industry simply by communicating with legislators. Here are the “5 Ws” of lobbying I’ve learned in my years of advocating for the industry:

Who: That’s you. Local facility owners, administrators, and staff know the issues, needs, and goals of our industry best and can explain them most effectively.

What: That’s working with lobbyists from the American Health Care Association/National Center for Assisted Living (AHCA/NCAL)—or other industry associations—in Washington. It’s also working with your state association. That way you can educate members of Congress, state legislators, and key staffers about legislative and regulatory proposals that impact our profession.

When: It’s done over time for establishing and maintaining relationships with legislators and on short notice for issues that require rapid response. Think of these relationships as you do any other personal relationships: if you engage with someone only when you need something—or have an “ask”—you are far less likely to be successful than if you’ve built a long-term, mutually beneficial relationship with that person. Invest the time and energy accordingly.

Where: You can communicate with members of Congress and state legislators in Washington, your state capital, in the district, or in your hometown.

Why: You work in one of the most highly regulated and critical industries in the country. We owe it to ourselves, our staff, and our patients to make our voices heard.

Sharing Your Knowledge

Legislators deal with a dizzying variety of subjects, from education and taxation to artificial intelligence (AI) and business regulation. While some specialize in certain areas, they need at least a working knowledge of many topics to cast an informed vote. While they have aides and research resources, they still to a large degree rely on their constituents to inform them of what’s going on in their industries and about their problems, concerns, and proposed solutions.

This is the opportunity for you to become more than just another voter. You know the issues around long-term and post-acute care; you know the problems and the impact of laws and regulations—you deal with them every day. You certainly know more than your local lawmaker. I know numerous instances of facility operators influencing the votes of lawmakers simply by sharing their knowledge.

By sharing your expertise, you can do more than just influence a lawmaker’s vote on a particular bill, you can become a subject matter expert and unofficial advisor to the lawmaker on industry matters. It can begin with a letter, phone call, or email. You can introduce yourself to the legislator at an event in the district. You don’t have to do this alone; your state AHCA/NCAL organization can help.

Of course, don’t harangue legislators: your communications should be concise, polite, and backed with facts and/or statistics supporting your position.

The Importance of the Inside Experience

I believe that one of the most effective ways to lobby at the grassroots level is to invite a lawmaker to your facility. State legislators and members of Congress spend a good deal of their time visiting businesses and groups within their districts and are generally open to invitations for tours. These can be great opportunities to make a strong impression on legislators and create a foundation for future collaboration.

While some people are intimidated by the prospect of traveling to Washington or a state capital to meet lawmakers, this is a chance to interact with them in a familiar environment in which you are the expert.

Writing a letter or making a phone call can have an impact, but not nearly as great as delivering insights and expertise during a tour of your facility. Not only will the lawmaker get a chance to see things for themselves, but it will establish your position as an expert, a trusted advisor, and a resource for the legislator.

You Can’t Win if You Don’t Run the Race

The problem with ignoring politics is that politics doesn’t return the favor.

It’s easy to dismiss politics as something that happens only in state capitals and Washington, DC, but that is a mistake. Politics results in policy and policy deeply impacts the long-term and post-acute care business. A lack of participation doesn’t buy you immunity from legislative decisions—it just means you don’t get a say in what’s decided.

You might think that’s the job of industry associations and professional organizations, and you would be right—to a point. Those groups work hard to advance the industry’s interest, but they can’t do it alone. Everyone in the industry, right down to the owners of individual facilities, needs to become a grassroots lobbyist.

About the Author

Bill Charnetski, LLB, is EVP, Health Systems Solutions and Government Affairs, at PointClickCare and a member of the AHCA Board of Governors.