Grassroots Advocacy

Grassroots advocacy is activism that originates among concerned constituents who rally behind issues they feel are not being addressed by government officials with the power and responsibility to act. It involves some level of political activity, with members of the society interacting with elected or appointed officials in an attempt to draw attention to their cause. It also means organizing and educating the community to get more constituents involved in the process. Grassroots advocacy often requires writing or calling officials, and attending meetings and events with elected officials. In short, it’s about constituents joining together to increase their strength and push for change.

Since the formation of the National Association of Independent Medical Equipment Suppliers (NAIMES) in April 2007, we have focused on this one main theme. We have always believed that all politics are local and that changing political minds must begin locally. We have talked about how “relationships at home equal grassroots power.” We realized that without suppliers working as their own lobbyists and developing a personal relationship with their representatives and senators, we would be unable to change the path of public policy for the DME industry.

In a way, grassroots advocacy is a game we must play, and we must now take this sport to another level. This is a contact sport, because without contact with elected and appointed officials we are ineffective. Since many of us are sports fans of some kind, let’s put grassroots advocacy in athletic terms.

The Field of Play
The equipment we need to play this sport is a pen, a computer and a telephone, and the playing field is your local district and state. There are usually one of two away matches in Washington, D.C., each year, and occasionally there will be a round played in the courts. The game starts when you and the constituent community feel that laws and policy decisions that are being made are inconsistent with the greater good of the community.

Play involves writing, calling, emailing and meeting with your elected officials to change their position on a particular issue. There may be multiple rounds in each game, sometimes involving multiple issues. The game may last for months or years, sometimes until there is a change in the players on the opposing team. You and your team are allowed to make power plays by bringing in outside consultants, lobbyists and patients to increase your influence. In order to win the game, you have to cause your elected official to not only change his or her position, but also to act on that change of heart. A stalemate occurs when you receive a positive response from your elected official, but they fail to take action to change the laws or policies.

Stalemates occur often, and to move forward more advocates must be brought into the game. When your opponent’s team members fail to respond to your requests, they can be removed from the game through the election process. The game is over when either the laws or policies are changed, or the DME team is too weak to continue.

The Rules of the Game
Never miss an opportunity to meet lawmakers when they are in their district, and never assume you can’t influence their thinking. Join your state DME association to increase your playing power, and also join national trade organizations to receive technical guidance about the game and the rules. Write, email or call your elected officials whenever the team leaders “ring the bell.”

Ask your DME colleagues to join trade groups to make the team stronger. Attend state and national events to ensure that you are well-versed on the issues, and do not quit the game because you lose one round—it’s only over when all the rounds are finished. And always remember that knowledge and information is the critical element necessary to make your play effective.

Though tongue-in-cheek, the point is that the DME industry is losing the fight to change the direction of politics and public policy because we don’t have enough suppliers involved in grassroots advocacy. We are currently too small in numbers and financial resources to impact our lawmakers. In an article a few years ago, NAIMES suggested that suppliers should “get into politics or get out of DME.” Now many suppliers will be getting out of DME involuntarily because of competitive bidding and onerous Medicare audits.

Could we have changed this path had we had more suppliers involved? Maybe, but we do know that we will not change the minds of our political leaders unless we have 10 to 20 times as many suppliers involved in the process. No trade organization representing DME suppliers can change the future without members. With just a few hundred suppliers out of a pool of over 15,000 belonging to either national trade group, the time is rapidly running out for suppliers to join in the contact sport of grassroots advocacy.