By Susan Plough, MSN, RN, PHCNS-BC, CCM and Debra Emery BS, CCM, CBIS

When we hear the words public policy, we tend to think about policy that is enacted at the national level. However, if we look at the definition of public policy, it is a set of laws, guidelines, and actions that are decided and acted upon by governments to work in favor of the public, the definition applies to every level of policy including state and local. Often the importance of advocacy for policy change at this level is overlooked.

At the state level, public policies involve laws enacted by the state legislatures, decisions made by state courts, rules developed by state bureaucratic agencies, and decisions made by governors and apply to everyone in the state, regardless of where they live.

As case managers, we must advocate for state and local policy change using the same tools we would at the national level.  We need to know what the issues are in our specific states. Of those issues do they include something you as a case manager is passionate about? It is also important to know who your legislators are at the state level and how to contact them. These are also elected officials and they want to know what their constituents think about legislation, just the same as at the federal level. It is also important to know the legislative calendar. Unlike the congressional legislators, state legislators are not all in session year-round. Only ten states have year-round legislators. The remainder of states have legislators that  are only in session 9 months of the year. Do not let that stop you. Even though they are not in session, most state legislators will use these months to get out among their constituents at local events. They welcome your input informally as well as a formal meeting. This is a wonderful time to utilize your state and local CMSA chapter or network of case managers to reach out to them and help on understanding healthcare issues. It is also a good time to share stories about case management and patient issues. Legislators need our stories to help them connect the dots. The results can start long-term relationships between legislators and case managers.

There are many ways that case managers can connect with their legislators at the state level.  To start the process, many states offer websites that simplifies the ability of locating your representative(s). Information such as their biography/background information, ways to contact them and what committees they serve may be included. This information can be valuable when meeting or speaking with them as it offers insight into their areas of expertise and interests. 

State Legislative websites can also provide information on the legislation that is currently in process. This information can be searched by bill number, topic/committee, or chamber of the legislature.    Some states may offer the ability to request email updates (based upon constituents committees/topics of interest chosen).  These updates can be received when new legislation is introduced, assigned to committee, approved by a chamber, or signed into law.  

After becoming familiar with the informational tools that are available, case managers can connect with their representative by attending a local coffee hour, participating in a hill day, or simply calling their representative.  There does not always have to be a specific reason to make a connection with your state legislator.  This can be an opportunity to introduce yourself, provide education as to what case managers do and offer your support as a resource.  Creating a relationship with your legislator can make the conversation seamless (and less overwhelming) should an “ask” or concern arise. 

During the month of April, our local chapter was fortunate to have the chair of the Senate Health Committee be our first “coffee hour” guest.  Education was provided about Case Management, about CMSA and ways we can provide support. It was a wonderful opportunity for discussion and sharing of ideas. 

Case managers are not only wonderful advocates for those we serve but can also serve as phenomenal advocates in the legislative arena as well.  Grass roots advocacy and the ability to influence change at the state level can be very rewarding experience.    

The CMSA Public Policy Committee serves to represent member interests on issues affecting care management professionals and their patients' wellbeing. Here's more information on current topics of interest to the CMSA Public Policy Committee. Learn more about how you can get involved here:

Bio: Susan Plough, MSN, RN, PHCNS-BC, CCM has a diverse background in both Nursing and in Case Management. She has served as Executive Director of Medical Management with Physician Hospital Organizations as well as Director of Hospital Case Management for both large multi- hospital healthcare systems and smaller Case Management departments in the Midwest. She is a Board-Certified Clinical Nurse Specialist in Community Health as well as a Certified Case Manager. Currently she is on the Faculty of Indiana University School of Nursing and does private geriatric case management for Senior1Care. Susan is Chairman of the National Public Policy Committee for CMSA and is a Board Member and Past President of the Central Indiana Chapter of CMSA. She is a Parish Nurse and Vice President of the Indiana Center of Parish Nursing. She has published nationally and has presented both locally and nationally on case management topics.

Bio: Debra (Deb) Emery, BS, CCM has served as case manager for spinal cord and traumatic brain injury survivors since 2011.  Debra was elected to the CMSA Detroit Board of Directors in 2020 and currently serves as the chairperson for the chapter's public policy and partners committees. Public Policy is a passion for Debra who serves on the CMSA National Public Policy Committee.  Debra lives in North Branch, Michigan with her husband and three dogs.  Debra and her dogs, Shelby and Cooper, enjoy competing in the sport of dock diving and looks forward to competing at the regional and (hopefully) national levels this fall.