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Engaging Stakeholders to Influence Policymakers and Shape Policy Outcomes

Situation A state non-profit organization engaged Martha Harbin to develop and execute a strategy to engage public health stakeholders to educate state legislators about the role and importance of county health departments. The state was facing massive budget shortfalls and the newly elected governor and legislative leadership were questioning the county health departments provision of primary care services and proposing to shift all of it to the private sector. To protect the organizations non-profit status, the effort could not include direct lobbying of elected officials. To protect the stakeholders position as public employees, the effort also had to empower them to take action as private citizens on their own time. Finally, the effort had to be executed with a very limited budget.

Solutions Of primary importance was the need to develop a concise message regarding the role of public health that resonated with state leadership. Due to their wide range of responsibilities, county health departments fill a number of public health roles that are not easily enumerated or explained in the time typically available to stakeholders meeting with policymakers. Recognizing the role of the states struggling economy in both the increased demand for public health services and the budget shortfall, the message tied the importance of a healthy workforce to companies seeking to locate in the state, the states tourism industry and demand for agricultural products from the state. Additionally, to overcome incorrect perceptions that a government agency must equal waste and swollen bureaucracy, Harbin understood the importance policymakers understood the efficiencies by which county health departments operate. The approached mapped the decision makers, identifying every county represented within a key legislators district. A delegation of local stakeholders was organized to meet with legislators in their district offices before the hectic pace of the annual legislative session began. For those counties, a one-page newsletter-style fact sheet was created containing key statistics illustrating increased demand for services, indicators of unmet healthcare needs and steps taken to increase efficiencies and reduce administrative staff to maintain and improve front-line services. The fact sheets also, whenever possible, contained real -life anecdotes illustrating a vital service provided by the local health department.

Finally, to create a simple method for stakeholders to communicate with their legislators, a website was created that included an advocacy application that visitors to the site could use to generate e-mail messages about the importance of public health. A variety of messages were created to allow visitors to select the one that most closely matched their area of concern along with the ability to customize the message. This helped to ensure legislators received unique communications from each constituent so that each e-mail was read by staff. Results County health departments under the new state administration and legislative leadership continue to operate in Florida at the same level of state funding and with the same mission as before. A dialog has been established that now includes public health as part of the solution to the states healthcare needs and not as an outdated model of providing services.