Make Your Voice Heard: Helpful Hints for Contacting Legislators

Meeting Face-to Face

The best way to begin a long-term relationship with a Member of Congress or a member’s staff is a face-to-face personal exchange. It enables your Member of Congress to connect your face to your subsequent letters and phone calls, giving them greater personal significance.

While it is not always easy to arrange a one-on-one meeting with your representative or senators, you can improve your chances by: (1) Getting someone who already knows the member to get you an appointment; (2) Arranging a group meeting with a number of the member’s constituents; (3) Meeting with the Member at one of his or her district offices near your home; or (4) Scheduling your Washington visit far in advance to make a meeting with the member more likely.

Another way to meet a member is to arrange for him or her to address a group of pharmacists for a question-and-answer session. The member’s appointments secretary in Washington, or a scheduling assistant in the district office, can help work out an appropriate time and place. You can also invite the member to your pharmacy (make sure this is ok with your employer) to see your practice first hand.

If you can’t arrange a meeting with the member as soon as you need to, remember that the member’s staff does most of the research on legislation. Ask to meet with the legislative assistant for health issues.

When you meet:

• Introduce yourself and state why you are there;
• Mention mutual friends/contacts;
• Emphasize key points that personally concern you;
• Keep the discussion brief;
• Expect questions and be responsive, not argumentative;
• Take a brief synopsis of your key points and supportive material to leave as a reminder;
• Be enthusiastic and show you care about the issue;
• If possible, get a commitment of support; and
• Follow up with a thank you letter, even if you were not successful.

Most important, have a specific objective in mind when you meet with your elected representative, and make sure the objective and your views are addressed during the meeting. Too often, constituents and representative spend their time in “social” conversation, and don’t engage in the proper mix of social and business talk necessary when important issues are being considered by Congress.
 

Do’s and Don’ts When Communicating with Legislators

Do:

• Clearly identify the subject in which you are personally interested, including House and Senate bill numbers, if you know them.
• Explain any business connections you may have relative to the issue, and the impact you perceive the issue will have on them.
• Write legibly and briefly.
• Use personal experiences to support your position.
• Use your own words on business or personal stationary.
• Restrict yourself to a single issue.
• Communicate while legislation is under consideration in committee, conference, or on the floor.
• Write more than once on the same issue if the legislation changes favorably, or unfavorably, and note why these changes will help or hurt you.
• Write to the committee and subcommittee chairmen responsible for the legislation if you have specific information that will help them make a more informed judgment on the issue (send a copy to your representative or senators).

Don't:

• Be rude or threaten.
• Pretend to have greater political influence than you really have.
• Promise something you can't deliver.
• Be self-righteous or all-knowing.
• Be vague about the issue (research your member’s position and present facts to support or refute it).
• Forget to thank the member for past favors.
• Bring up past campaign contributions or present a check during your meeting. (This should be done at events specifically for fundraising.)
   

What Your Legislator Needs from You

• Timely and correct information on pending or proposed legislation, together with your best estimate of the legislation’s local and/or national impact.
• “Thank you” letters;
• Exposure to constituents, such as:
  • photo opportunities when they’re home visiting
  • speaking engagements before constituents on health issues
  • receptions at which to meet community pharmacists and pharmacists’ supporters from the community
  • favorable publicity in the local media on stands they have taken
  • appearances on local radio/TV talk shows, and
  • fundraising and other volunteer help in campaigning for office.

Getting public visibility for your legislators is not as difficult as it may seem, as long as you understand and respect the conditions and time frames that govern the busy schedules of media representatives. For example, when publicizing a special event, such as the appearance of a member of Congress at a meeting of local pharmacists, make sure you are aware of the daily and weekly press publication schedules and the electronic media’s programming schedules. Also, try to schedule such events so as not to conflict with other matters deemed by the media as “more important.” If, for example, your local TV station is invited to attend your group’s presentation of its ”pharmacist of the year” award on the same evening that the city’s first female mayor is sworn in, which event are they going to cover? Sometimes you may have an important story that warrants “exclusivity”—for instance, your organization may have played an inside role in a controversial issue or it may have conducted a breakthrough study whose findings you wish to release through one influential source. In such cases, the media representative—who most likely publishes under his or her byline—will want a guarantee that the story is being given to him or her alone. When working on a story with a reporter, be sure they know whether it is an “exclusive.”

It is extremely helpful to develop a professional working relationship with key media representatives, since these people can give you insights into getting your message out to the public. And try to direct the information you want publicized to the proper media source. Radio and television news directors and assignment editors decide who will cover a given story. Newspapers and magazine editors decide whether to publish your “letter to the editor” or other newsworthy items. Both groups have deadlines. Respect them and they will be more responsive to your future requests.

Guide to Scheduling a Local Pharmacy Visit

Tours of your pharmacy or practice site provide one of the most effective methods of communication between you and your federal legislators.  Visiting a pharmacy or practice site gives legislators a valuable opportunity to develop a good sense of the role pharmacists play in the community and on the health care team.

Site visits such as these are particularly useful for introducing legislators to a large number of constituents and voters, and most legislators and their staff want to know as many of their constituents as possible. Showing how pharmacists help patients in a real world setting also helps humanize the issues for legislators.

Below are some tips on how to schedule and conduct a visit with your Member of Congress at your local pharmacy or practice site.

Check the Congressional Calendar

• Check the annual Congressional Calendar to find out when your state’s representatives will be back in their district/state.
• The best times to schedule a visit are during a congressional recess, also known as a “district work period.”

Contact the Member of Congress's Office

• Email or call the local district office or DC for your legislator with the invitation.
  
  • The contact information is listed on the Member of Congress’s official website.
  • Ask to speak with the staff member who sets the local schedule for the Member of Congress.
• Always introduce yourself as a pharmacist and constituent (“Hi, I am Amy Smith, a pharmacist from Portland, Maine”).
• Mention where you practice (“I practice at Harry’s Pharmacy on Franklin Street in Portland”).
• See sample invitation letter below.
• Make sure you plan a visit at least 2 weeks in advance, preferably a month or more.  If the Member of Congress is unavailable, ask to schedule a meeting with the District Director or the staff aide who serves as the primary liaison between the Member of Congress and the health care community.
• Plan on 30 – 60 minutes for a meeting.
• Don’t be discouraged if it takes several invitations before the legislator accepts. Legislators have many demands on the time they spend in the district or state. Your persistence will pay off.

Preparing for Your Visit

• Develop a schedule that allows enough time to tour the facility and to enjoy informal discussion. If the legislator’s schedule permits, plan for a small luncheon or reception following the tour.
• Find out who will be accompanying the legislator.
• Consider whether in advance of your visit you need to inform any “higher-ups” in your organization or the public relations department of the Member of Congress’s visit?
• Choose the right staff or colleagues to include.
  
  • Try to include colleagues or associates who you know are politically active locally or who have a special relationship with the legislator or staff member.
  • Let those invited know the exact date and time of the visit in advance.
  • If possible, share the highlights of the legislator’s biography with your colleagues and associates who will be present.
  • Brief all participants on the legislative issues you will discuss and assign roles.
• Localize the issue whenever possible. If there is a particular need in your community (e.g. high diabetes rates, limited public transportation, highly rural), provide specifics of how pharmacists can help.
• Ensure that any helpful resources or other materials are available for distribution to the staff at the meeting.
  
  • Use the resources at APhA Advocacy Issues to check out APhA’s issue positions
  • Data how pharmacists are trained and accessible providers.
  • APhA Government Affairs staff can help by providing educational materials such as legislative issue briefs.
• Be prepared to answer questions such as:
  
  • What patient population does your pharmacy serve?
  • Where does most of your revenue come from?
  • What services do you provide? Which are most helpful? Which are the most used? Which are most underutilized?
  • What outcomes have you achieved?
  • What are the challenges you face in serving your patients?
  • What type of demand does your community have for your services?
• Prepare a HIPAA form for them to review and sign before a tour. This is always a nice way to show that you take patient privacy seriously and elevate in their minds the work that you do as a pharmacist.

During the Visit

• Keep the visit focused to encourage questions and open discussion.
• Focus on one or two clear messages to the Member of Congress and ask them their position.
  
  • Brief the Member of Congress on the patient care services that you provide and the typical patients that you see.
  • Make the connection between your efforts improving your patients’ health and how it should be considered in health care reform or deficit reduction plans.
    
    • Provide examples of how pharmacists working with patients have improved health care and decreased costs to the overall system through counseling, MTM, etc.
    • Demonstrate how you are one of the most accessible health care providers in your area.
    • Demonstrate your work with Medicare Part D beneficiaries and how your services have protected seniors.
• Whatever you do, don't give them a PowerPoint presentation. Instead, aim for a conversation. Use the opportunity of a site visit to let a legislator see your team in action.
• Tour the pharmacy.
  
  • Brief the Member of Congress on the statistics about the typical patient populations that you serve and their needs, what you provide them and how it relates to APhA’s position on increasing the role of the pharmacists.
  • Allow the legislator to question and gather information.
  • Depending on your practice environment, plan on modeling a screening or patient counseling. Show your documenting and billing procedures for this services.
• Acknowledge other staff and their role at the pharmacy.
  
  • Introduce colleagues by name. Remember, all citizens are constituents and potential voters.
  • Ensure that other staff know in advance and use formal salutations.
• Demonstrate the services you provide to patients such health screenings, medication therapy management, counseling, and immunizations.
• If appropriate, arrange to have someone take photos of the visit.
• If the legislator’s schedule will not permit an informal luncheon or reception, conclude the tour or visit with a short private discussion. It might be advantageous to arrange for the legislator to meet with selected colleagues or other community leaders. In either case, discuss the issues of greatest importance to the pharmacy profession and to your patients and community.
• Give your contact information and any materials for the legislator to take with them.
• Get contact information for the person with whom you should follow-up.

Post-Visit

• Follow up to thank the legislator and their staff for their participation.
  
  • Send a thank you email or letter detailing highlights of the visit.
  • Include any photographs from the visit or copies of any media coverage.
  • See sample thank you letter below.
• Report to APhA on your visit. This is particularly important if any follow-up is necessary.
• Keep in regular contact with your Member of Congress.

If you have questions or need assistance, please contact Doug Huynh at 202-429-7573 or dhuynh@aphanet.org.

Sample Talking Points

• DIR Fees Increase Costs for Patients and Pharmacies
• Patients are negatively impacted by insurer and pharmacy benefit manager (PBM) practices such as direct and indirect remuneration (DIR) fees under Medicare Part D that mask the real price of medications, increase the price patients pay and interfere with pharmacists’ ability to provide patient care.
• Retroactive DIR fees or other “clawback” mechanisms, often assessed months after a prescription has been filled, prevent pharmacies from knowing at the time of dispensing what their true reimbursement will be for a prescription. The result is a final reimbursement often below the cost of the medication paid by the pharmacy to its wholesaler. These DIR fees have no relationship to what the pharmacy actually paid for the product. Pharmacies simply cannot dispense products below their actual cost.
• Because current point-of-sale prices or copays paid by beneficiaries at the pharmacy counter can be based on the contracted price before DIR fees/clawbacks are extracted, many Medicare beneficiaries actually pay higher out-of-pocket costs. The Centers for Medicare and Medicaid Services (CMS) has cited numerous research that suggest higher cost sharing by patients can impede beneficiary access to necessary medications, which leads to poorer health outcomes and higher overall medical care costs for both patients and Medicare.
• Complex PBM coverage and payment policies also hinder the full potential of community pharmacists’ clinical education and training from being realized as much of their day is spent on the phone trying to find an appropriate treatment that is not only covered, but the patient can afford.
• Recently, CMS missed an opportunity when the agency failed to include proposed retroactive DIR fee reforms when it finalized a recent proposed rule, “Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses,” (CMS-4180-P). The proposed rule would have passed on any price concessions from drug manufacturers and pharmacies, including DIR fees, onto Medicare beneficiaries as real cost savings at the pharmacy counter.
• In the proposed rule, CMS cited the fact that DIR fees on pharmacies participating in Part D grew by 45,000% between 2010 and 2017. This significant increase in DIR fees creates uncertainty for community pharmacists and the patients we serve, and jeopardize the viability and accessibility of community pharmacies and pharmacists
• CMS estimated that proposed reforms to eliminate retroactive DIR fees and share these savings with patients at the pharmacy counter would have saved Medicare beneficiaries between $7.1 and $9.2 billion in cost sharing over the next ten years.
• Pharmacy DIR fee reform is needed immediately to bring down beneficiary out-of-pocket costs, avoid further losses to pharmacies, including closures, that reduce patient access to care. The need for reform is NOW if patients are to retain access to convenient and effective pharmacy services.
• We need Congress to pass legislation that would:
  
  • End point-of-sale price concessions, such as retroactive pharmacy DIR fees, to ensure consistency throughout all of the Part D benefit.
  • Establish standardized pharmacy quality measures for CMS to provide incentive payments to pharmacies.
  • Require that Part D sponsors include suitable claim-level detail on the electronic remittance advices that accompany payment.
• Add your own talking points to personalize the issue. If you are a practicing pharmacist or student pharmacist, talk about the impact you are having on patients and the problems caused by DIR fees. Describe how the bill would help.