What can we do to influence the legislature in making positive changes in the healthcare industry, its environment and its regulations, especially as it relates to rural health systems?

Community organizers, though they may be successful in prompting growth or improvement at the grassroots level, soon realize that to effect global changes, they must also attack the problem from the top. This usually means influencing legislators in their role as lawmakers and regulators of the healthcare environment.

To successfully influence lawmakers, it is incumbent on community groups to not only stay abreast of legislative activity in general, i.e., the actions of health-related committees and the status of bills being sponsored in the current session, but also to develop a working relationship with specific legislators who demonstrate a keen interest in health services and access issues.

Legislators, when asked, will often candidly admit that they find the health care system, especially health care finance, extremely difficult to understand. Lawmakers say they have a hard time grasping the scope of the issue, such as first comprehending the groups and agencies that fall under the purview of any given legislative subcommittee. Then, they must also deal with physician and allied health licensing, public health concerns, clinical debates, health insurance and health care financing issues and scope-of-practice questions, while realizing that their votes will ultimately affect access to and quality of health care services in their state or the nation.

In trying to balance the clamor from constituency groups espousing competing issues against the clarion call of budget bottom lines, legislators search for experts to help them debate the issues. This is where a well-informed community group can enter the fray. While policy “wonks,” paid lobbyists and special interest groups present certain points of view, well-informed community groups can function as respected information specialists by feeding their legislators region-specific data, anecdotal evidence, and credible policy input from their local standpoint.

It is important for community groups to keep in mind that legislators are just like everyone else in that they look for trustworthy support sources who will “help them do their job better.” In this regard, establishing a rapport with legislative office aides is helpful, as is learning a given legislator’s preferred communication style, while bearing in mind that each Texas session is only 140 days long.