ACS Chapter Lobby Days Program: Surgeons work the halls of state capitols to advocate for the profession

The American College of Surgeons (ACS) Chapter Lobby Day Grant Program, now in its seventh year, provides financial support for chapters to conduct state capital lobby days. Fellows, residents, and members of the ACS participate in state lobby days to advocate for legislation that will improve patient safety and quality, and to educate lawmakers about their chapter’s legislative priorities.

ACS chapters in 12 states—Alabama, California, Connecticut, Florida, Georgia, Illinois, Indiana, Kansas, Massachusetts, Oregon, Texas, and Wisconsinreceived matching grants through the grant program to help fund lobby days at the state capitol in 2017. The financial grants can be as much as $5,000 with a $2,500 match, along with ACS State Affairs staff support for planning and on-site implementation of the lobby day event. This year, the ACS launched a Chapter Advocacy Initiative Pilot Program, which carries a larger grant of $15,000. It was made available to one chapter that provided a plan to engage the state legislature on a high-priority issue.

GSACS uses new initiative for Stop the Bleed® training

The Georgia Society of the American College of Surgeons (GSACS) received the first Chapter Advocacy Initiative Pilot Program grant to conduct Stop the Bleed training in the state capitol building and develop a legislative campaign to advocate for an additional $1 million for the state’s Georgia Trauma Commission (GTC) to purchase bleeding control kits for public schools. The training took place in four locations on Georgia’s Capitol Hill during the February 7 lobby day. Additionally, the GSACS purchased and donated three large bleeding control kits, which were installed in the capitol building and the adjacent legislative office building.

John Harvey, MD, FACS, demonstrates to the media how to apply a tourniquet, at the Georgia state capitol, February 7, 2017

John Harvey, MD, FACS, demonstrates to the media how to apply a tourniquet, at the Georgia state capitol, February 7, 2017

In anticipation of the training event at the state capitol, both the Georgia House of Representatives and the Georgia Senate passed special resolutions declaring February 7, 2017, as Trauma Awareness Day. The GSACS President-Elect and GTC Chairman, Dennis W. Ashley, MD, FACS, accompanied by R. Frederick Mullins, Robert S. Cowles III, John C. Bleacher, and Colville H.B. Ferdinand (all MD, FACS), and trauma survivor Ashley Power, addressed the senators and accepted the Trauma Day resolution on the floor of the Senate.

The GSACS also held a rally and news conference outside the capitol building featuring Drs. Ashley and Cowles and Ms. Power. Ms. Power was reunited with GSACS members James R. Dunne, MD, FACS, and Heather G. MacNew, MD, FACS, two of the trauma surgeons who cared for her. During the press conference, Peter M. Rhee, MD, FACS, a GSACS member, introduced Gwinnett Police Officer L. L. Hurst, who described how within days after training, he applied what he learned through the Stop the Bleed training to save the life of a bystander wounded in a drive-by shooting. The media reports about Georgia’s Trauma Awareness Day and Stop the Bleed program reached more than 4 million members of the public (see photo).

“The ACS Chapter Lobby Day Grant Program is a direct investment in ACS chapters and members. Georgia’s Trauma Awareness Day would simply not have occurred without the ACS support,” said Dr. Ashley.

Trauma care and funding

The Alabama, San Diego, Northern and Southern California, and the North and South Texas Chapters also focused their lobby day efforts on trauma care and funding in 2017. The Alabama Chapter’s lobby day took place April 19 and centered on funding for the state’s trauma system. At present, no public funding has been allocated to the Alabama trauma system. Lobbyists for the Medical Association of the State of Alabama kicked off the event with a brief presentation on the challenges facing the state, including ongoing budget negotiations to fund Medicaid, as well as leadership issues arising from the sudden resignation of Gov. Robert Bentley (R) April 10 and the transition to Lt. Gov. Kay Ivey, who immediately took over as governor. State Sen. Larry Stutts, MD (R), an obstetrician-gynecologist, stopped by the morning session to discuss the importance of the trauma system for patient care and acknowledged the challenge Alabama has with hospital closures, including the closure of Level II trauma centers, resulting in additional pressure on the state’s Level I trauma centers. Lobby day participants met with Senate Majority Leader Greg Reed (R), who agreed that the state trauma system needed to be funded, but emphasized the challenges to funding Medicaid and the uncertainty about how congressional action on the Affordable Care Act (ACA) would affect the Medicaid program.

J. Patrick Walker, MD, FACS (left), and staff for Sen. Robert Nichols (R), examine a bleeding control kit at the Texas state capitol, February 23, 2017

J. Patrick Walker, MD, FACS (left), and staff for Sen. Robert Nichols (R), examine a bleeding control kit at the Texas state capitol, February 23, 2017

The San Diego and Northern and Southern California Chapters focused their advocacy efforts on passage of Assembly Bill (AB) 909, which would require the installation of bleeding control kits containing tourniquets, pressure dressings, and Stop the Bleed branded instructional materials in all public places in the state. Leaders of the San Diego and Northern and Southern California Chapters testified at a committee hearing on AB 909. Their joint lobby day April 18 included bleeding control training and demonstrations for legislators and staff, as well as the general public, in the capitol building.

The North and South Texas Chapters of the ACS incorporated the Stop the Bleed campaign into their lobby day February 23, with a table in the capitol office building where chapter members demonstrated how to control bleeding through the use of tourniquets and gauze. Chapter members brought sample bleeding control kits to their meetings with state legislators to familiarize lawmakers and legislative staff with the value of making the kits widely available (see photo). They also used the opportunity to raise the issue of increasing the state’s funding for graduate medical education. Rep. Trent Ashby (R) introduced a resolution recognizing the Stop the Bleed campaign and encouraging Texans to participate in the initiative.

The North and South Texas Chapters’ lobby day took place in conjunction with a joint chapter annual meeting in Austin. Including the lobby day as part of the annual meeting enabled the chapters to increase the number of members able to meet with state legislators.

Chapters make lobby days a collaborative effort

The Indiana Chapter of the ACS scheduled its lobby day to be part of the Chapter Winter Meeting February 7. The lobby day included a keynote address by Jennifer Walthall, MD, Secretary of the Indiana Family and Social Services Administration (FSSA). Dr. Walthall gave an overview of the responsibilities of the FSSA and spoke about the impact of the opioid epidemic in Indiana. Jerome Adams, MD, an anesthesiologist and Commissioner of the State Department of Health, stressed the importance of physician advocacy and involvement in the development of health care policy. Attendees met with more than a dozen legislators to discuss opioid prescribing restrictions and out-of-network surprise billing.

The Connecticut, Kansas, and Wisconsin Chapters joined with their state’s medical societies and other physician groups to demonstrate a unified voice for medicine with state legislators.

The Connecticut Chapter of the ACS jointly sponsored the Physicians’ Day at the Capitol with the Connecticut State Medical Society March 16. ACS surgeons and residents dug out from a late winter blizzard the day before to speak to legislators about the need for the state to adopt a definition of surgery and to identify ways to limit growing licensure, insurance, and living costs in the state in an effort to keep surgeons in the state after they complete their residency.

The program for the Connecticut lobby day included a morning meet-and-greet with members of the joint Public Health Committee, including Co-Chairs Sen. Heather Sommers (R) and Rep. Jonathan Steinberg (D), as well as Rep. William Petit, MD (R). After individual meetings with legislators, the participants attended a luncheon that featured presentations by Rep. Prasad Srinivasan, MD (R), a practicing physician and candidate for governor in 2018; Raul Pino, MD, Commissioner of the Department of Public Health; and Jonathan Harris, Commissioner of the Department Consumer Protection. Dr. Pino and Mr. Harris both addressed concerns about the state’s policies on mandatory use of the prescription drug monitoring program for opioids.

The Kansas Chapter of the ACS collaborated with the Kansas Academy of Family Physicians and the Kansas Chapter of the American College of Emergency Physicians to sponsor a lobby day January 24. Discussion focused on efforts of moderate Republicans and Democrats to expand the state’s Medicaid program to receive additional federal dollars through the ACA.

The program featured speeches by House Minority Leader Jim Ward (D); Senate Assistant Majority Leader Vicki Schmidt (R), Chair of the Senate Public Health and Welfare Committee; Rep. Dan Hawkins (R), Chair of the House Health and Human Services Committee; and House Majority Leader Don Hineman (R). Each spoke about the opportunity to expand Medicaid, but also emphasized that Gov. Sam Brownback (R) staunchly opposes these efforts. Also discussed was the need to address the state’s financial crisis, which would likely require increasing taxes. In addition to voicing support for Medicaid expansion, Kansas Chapter members spoke with legislators about the need for insurance coverage of bariatric surgery and services.

The Wisconsin Surgical Society, a chapter of the ACS, sponsored Doctor Day 2017 on March 29, joining more than 400 physicians from around the state (see photo below). The main program included an update from Michael Heifetz, Director of Badger Care, the state’s Medicaid program. Mr. Heifetz made it clear that the state has no intention of expanding Medicaid, despite vocal objections from some physicians in the audience. The program also included a panel discussion featuring Reps. Debra Kolste (D) and Kathy Bernier (R) about the political environment in the state capitol and its impact on the development of health care policy.

“State lobby days are an important opportunity for surgeons to connect with their state legislators to reinforce their commitment to the total care of their patients (and the legislators constituents), at all levels including in the clinic, in the hospital, in follow up, and in the public health priorities and financial realms of legislation,” said Amy Liepert, MD, FACS, member of the Wisconsin Surgical Society and ACS Health Policy and Advocacy Group. “It is an opportunity to express the importance of this commitment, by making time in the recognized packed surgeon’s schedule to visit the legislator in the state house. The impression that this leaves with legislators demonstrates the commitment of surgeons to the total care of patients, is truly unparalleled, and is a great investment toward building future relationships.”

Physicians gathered outside the Wisconsin Senate Chamber for Wisconsin Doctor Day 2017

Physicians gathered outside the Wisconsin Senate Chamber for Wisconsin Doctor Day 2017

Lobby days at state capitols offer the opportunity for surgeons to meet with legislators in an environment where they are focused on the issues being debated in the legislature. It also is a great opportunity for surgeons, and especially residents, to see firsthand the legislative process at work, and to understand the value of building relationships with their legislators. While there may not be a major policy or piece of legislation for chapters to advocate on every year, hosting a lobby day is still a great opportunity to cultivate those relationships. The Florida, Illinois, and Oregon Chapters used their lobby days to build relationships and share the surgical perspective on the health care issues before their legislatures.

The Florida Chapter of the ACS held its lobby day January 10. Rep. Julio Gonzales, MD (R), an orthopaedic surgeon, addressed participants about the benefits and challenges of being a physician member of the legislature. Several members had the opportunity to spend an hour with Carol Gormly, Health Policy Advisor to Florida Speaker of the House Richard Corcoran (R). Chapter members spoke with their legislators about important health care issues, including scope of practice, telemedicine, and recovery care centers.

Surgeons from the Metropolitan Chicago and Illinois Chapters of the ACS gathered in Springfield May 10. Lobby day participants met with targeted members of the House and Senate to advocate for H.B. 311, an insurance network adequacy bill, and to oppose S.B. 642, which would allow advance practice nurses to practice independently, prescribe opioids, and to advertise as medical doctors.

The Oregon Chapter of the ACS hosted its state lobby day March 12–13. Rep. Knute Buehler, MD (R), spoke at a dinner the night before the day in the capitol. Dr. Buehler, an orthopaedic surgeon, focused his comments on tips for effective advocacy. During a briefing session the following morning, Courtni Dresser, director of government relations for the Oregon Medical Association, described the condition of the state, particularly with respect to Medicaid financing and the state budget. James Rickards, MD, MBA, the Chief Medical Officer of the Oregon Health Authority, further emphasized the difficult Medicaid budget situation.

Sen. Laurie Monnes-Anderson, RN (D), Chair of the Senate Healthcare Committee, also spoke about the difficult budget situation in the state, and indicated uncertainty regarding what would happen with the ACA. Changes to the health care law could necessitate that the state allocate considerably more funding to the Medicaid program in order to compensate for cuts in federal dollars. After the presentations, surgeons met with their elected officials to discuss chapter-supported legislation, such as a bill requiring children younger than two years old to be properly secured in a car seat in a rear-facing position.

While most state legislatures conduct their business during the first half of the year, a few states meet year round, which provides an opportunity for chapters to schedule their lobby days later in the year. The Massachusetts Chapter of the ACS is planning its 2017 lobby day for October 16.

Chapters that do not apply for or receive an ACS Chapter Lobby Day Grant are not precluded from engaging in lobby day activities. The Virginia Chapter of the ACS has partnered with the Medical Society of Virginia and other physician groups to host a lobby day January 30, 2018. The ACS encourages chapters and members to make use of opportunities to partner with other organizations hosting state lobby days. Alternatively, members can schedule time to meet with their legislators in their home district to build relationships and educate them about the issues of importance to surgeons and surgical patients. The ACS State Affairs staff is available to assist chapters and members with advocacy activities.

Applications for the 2018 ACS Chapter Lobby Day Grant Program have been sent to chapter leaders and administrators. The deadline to submit the application is September 15. For questions or more information about the program, contact Christopher Johnson at cjohnson@facs.org or at 202-672-1502, or visit the ACS website.

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