Understanding and Influencing Policies

Whether it is legislative policy that dictates the level of funding a research project receives, or a private health insurance policy about which treatments are covered, policies affect cancer outcomes.

That is why policy—public, private, federal and local—is an important part of solving cancer-related issues. By getting involved, you are making sure your community leaders are representing you. For the following examples, an individual solution may exist, but there also may be a better system to put in place that would eliminate or reduce the problem for all people affected by cancer. This could require some change in policy or practice.

• A treatment center could rearrange its appointment schedule to accommodate multiple patients from a particular area and offer transportation service to and from that area on treatment day to alleviate stress for the patients and their families. The center also could provide a mechanism for those patients to get support from each other during their treatment trips.
• An insurance carrier could change its reimbursement policies to be more inclusive of a variety of cancer treatments or a state could mandate by law that insurance companies cover certain treatments.
• A state university system could create a campus cancer program for students at all of their college campuses and extension offices.

These examples illustrate how an individual problem is actually a cancer issue and that cancer issues can be alleviated or resolved through policy change.

1. Considerations for Policy Priorities

When you are deciding what project you want to take on, think about how your actions can not only help that issue but also help to build momentum and strength. There may be local or regional issues that you want to tackle.

Consider if those projects:

• Have a human face or story to tell that helps people relate to the problem on a personal and emotional level. This could increase your chances of getting their support and involvement.
• Have broad appeal not only to the people you are working with, but also to others in the community affected by cancer, so that they will be more likely to join you.
• Have a local angle. Often people are more motivated and interested in their own communities than they are in a place in which they are not familiar.
• Establish priorities that are easy to explain and understand so that you are not bogged down in technical jargon or confusion within the grassroots ranks.
• Inspire passion in your most deeply committed advocates so they will stick to it and convey their energy to others.
• Set priorities that can be influenced in a realistic amount of time (months vs. years). That way you will be able to celebrate victory and achieve a solid sense of accomplishment.
• Have a clear solution to advance. Pointing to problems without solutions is demoralizing.
• Associate with an identifiable decision-making body, such as a board of directors or elected body. This will give you individual people you can go to if there is a need to make changes.
• Lend themselves to a clear victory that you will be able to celebrate and publicize.

2. Understanding how policy decisions are made

Having a person designated to address public policy for the organization is valuable. They are dedicated to observe, understand and explain the impact of public policy. This person can also lead lobbying efforts if and when necessary. Lobbying is any activity designed to influence a decision maker toward a desired action, most often through legislation. Organizations need to make sure that they follow all relevant local, state or federal laws before engaging in lobbying activities.

Government systems are complex; therefore, designating one individual to monitor public policy will assist in educating other employees, constituents and affiliates.

Before beginning any advocacy activity, you must have a sound understanding of the issue and process you are seeking to influence. Research how an issue is decided and who will inform your strategy every step of the way. This is true whether you are seeking to change public policy, such as a law or ordinance, or private policy or practice such as the delivery of a service, administration of an insurance plan or dissemination of a human resource benefit. The key to good research is obtaining adequate detail.

• Who makes the ultimate decision about your issue?

You will need to identify those people directly involved in making decisions about the issue—individuals, committees, departments or groups who can facilitate, approve and/or ensure the change you seek. Use these guiding questions to identify your decision-makers:

• Is it one individual or a committee?
  If it is one individual:
  • Is the individual elected or appointed? What are the terms?
  • Can anyone override the individual's decision?
  If it is a committee:
  • How is the committee structured?
  • Who votes and who doesn't?
  • Does anybody have veto power?
  • Are members elected or appointed? What are the terms?
  • Do they represent anyone, formally or informally?

Examples of decision-makers:

• Elected officials, such as state or federal legislators, mayors, county commissioners, city council members or school board members
• Officials who are either elected or appointed, such as library or park board members, or health department administrators
• Boards of directors of for-profit or non-profit organizations, such as hospital, insurance company or non-profit boards
• Employers, human resource directors, institution staff (such as school superintendents, principals, presidents or staff)

• What is the process required to change the issue you are working on?

Use these guiding questions to clarify the decision-making process:

• Can individuals submit a request, or does a member of the decision-making body have to introduce the change?
• What individuals can make a request?
• Once a request is in motion, what are the steps? What is the timeline, and how can it be influenced (sped up or slowed down)?
• Are there legal or regulatory guidelines related to your issue? If so, what are they, and how do they influence a change in policy?
• Is public input allowed or required?

• Map it.

As this information is obtained, it may be helpful to "map" the process by creating a diagram that identifies each step and the individuals associated with each step.

No matter how you contact a decision-maker—whether it is by mail, in person or on the phone—your contact should be designed to persuade and motivate that decision maker to help. When you communicate with decision-makers, there are several things you can do. The Characteristics of Persuasion Worksheet will help you be a persuasive and effective advocate during your interaction.

3. Worksheet

• The Characteristics of Persuasion Worksheet

4. Resources

LIVESTRONG: Cancer Policy Platform

Alliance for Justice: http://www.afj.org/

THOMAS has content such as Bills and Resolutions, Activity in Congress, Congressional Record, Schedules and Calendars, Committee Information, Presidential Nominations, Treaties, Government Resources and voting records: http://thomas.loc.gov