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									New York City Department of Health and Mental Hygiene
  Bureau of Maternal, Infant and Reproductive Health

     Harlem Strategic
     Action committee

Advocacy training Guide
 Working Together for Change

                   March 2007
                                  The Advocacy Cycle

Done right, advocacy is a process that develops and strategically invest social capital.
Social capital refers to the products of reciprocal relationships and networks (i.e. trust,
fellowship, support, sharing of resources, etc.).

                                           Identifying &

                                                                            Assessing the
         Taking Action,
         Affecting Change

                                      Developing Action
                                     Strategies, Building

Components of policy work:
Policy work is an iterative process, meaning it is ongoing, reflective, and cyclical. The
advocacy cycle depicted above is comprised of four overlapping phases and many
ongoing tasks.

   1. Community Needs Assessment – Community needs assessments investigate
      a wide range of conditions in the community (population demographics, housing
      stock, disease rates, economic factors, etc). When a partnership is formed in
      response to an identified issue, community needs assessments can contribute to
      a more complete picture of a community. An assessment can also be used to
      gain an understanding of the range of issues faced by a community and to
      identify some of the community‟s strengths. Finally, community needs
      assessments can be conducted throughout the course of a project, policy
      intervention, or advocacy initiative, as an evaluative tool to assess the impact of
      policy changes. In coalitions it is useful to take stock of the community members‟
   impressions at the outset and look for evidence of the magnitude of the problems
   they have identified.

   For example, in the Harlem Urban Research Center's Community Action Board –
   a community-academic partnership - many community members reported that
   nearly everyone in the community knows someone involved in the criminal justice
   system. In a community poll they then conducted they found that 32% of
   respondents knew someone personally who had returned from jail or prison in
   the last 12 months. This finding helped to confirm and community members
   impressions, and to back them up with data.

2. Prioritizing community issues – Many coalitions evolve in response to a
   pressing community issue. However, for those coalitions that have general
   community improvement goals, prioritizing the issues facing the community will
   be an important and challenging task. Community needs assessment can help
   to guide this process. However, the group should generally be guided by what
   excites and moves it to action. Also the expertise of the members should be
   taken into account. If expertise is lacking in the group, additional members can
   be asked to join.

3. Assessing the Political Landscape – In addition to learning about any science
   related to your target health outcome, the policies that are impacting that
   outcome, and the community views of the issue, a partnership needs to learn
   something about the context in which the policy is being practiced.
   Understanding the political and economic environment that surrounds the issue,
   identifying the stakeholders related to the issue, and identifying relevant policies
   will set the stage for the development of an effective change strategy.

4. Doing your homework: Research – The more information you can gather about
   your chosen policy or practice and its social and political context, the more
   prepared you will be to take effective action.

5. Agenda Setting – While the coalition is developing a sophisticated
   understanding of the issues, it can also begin to develop recommendations for
   changes in policy or practice. It is useful to think about both ideal changes and
   changes that are achievable. The ideal (e.g. universal healthcare, living wage,
   alternatives to incarceration for youth) will guide the development of
   recommendations tailored to the current political and economic climate.
   Breaking down the ideal overall goal into specific policy recommendations for
   short, medium, and long range time frames allows the coalition to pursue multiple
   strategies with multiple decision-makers.

6. Coalition Building (Broadening your coalition)– Developing allies is often a
   critical component of a policy change strategy. However, it also represents a
   challenge to a coalition's ability to stay focused and to set the agenda.

7. Action – Action is the mechanism used to achieve your policy goals. Action
   includes all processes that lead to desired outcomes (e.g. media campaigns,
   negotiations, program development, etc.).
   8. Reflection and Evaluation – After a successful change in policy it is critical that
      coalition members monitor the impact of the change on their communities.
      Whether or not your actions produced the desired results, reflecting on the
      process used to achieve change can both bolster the group's confidence and
      highlight useful lessons learned for future campaigns.

The rewards of strategic policy work
While policy work is time consuming and requires considerable resource investment, it
also has many rewards. These rewards include both the political and the personal.
     Building Social Capital – Growing Stronger
     Developing Skills in the Community and in the institutions that serve the
     Achieving Change
     Improving Social Policy
     Creating a more democratic society
               Assessing Issues: Choosing an Issue to Work On

Deciding which issue to address can be a daunting task. There are so many policies
and practices that affect health in our communities that it can sometimes seem
overwhelming. For this reason it is useful to choose as a first project, changing a policy
that is amenable to change – meaning one that can be changed without a miracle or
radical change in the political environment - or choosing a project that will help to build
resources. An early victory will go a long way to building the trust, optimism, and
commitment among change agents necessary to meet other goals. If you are embarking
on a long-term policy intervention with substantial resources, you should also select
broader more difficult to change policies as a target of your efforts.

To guide your choice of policy priorities consider the following questions:

How much damage does the current policy do, both with respect to the number of
people affected and with respect to the intensity of the damage to each individual?

       Policies that harm a lot of people have a natural base of support for change.
       However, if the impact is small, people may not be willing to invest time or energy
       in changing the policy.

       If there is a policy or practice which is severely affecting the lives of a relatively
       small group, that small group and their family and friends may be extremely
       motivated to work toward change. For example, spinal cord injuries are relatively
       rare, but devastating to the individual and their families. Therefore they work
       very hard to find successful treatments. Christopher Reeve's foundation has
       been one of the leading organizations doing public education around stem cell
       research to try to get public support and public funding.

       The importance of any given policy to your community should guide your
       decision. Also consider the strength of potential allies for each issue.

Is this a policy or a practice?

       A policy is a rule, regulation, or legislation that governs action. Policies include:
       regulated incentive systems such as government grant making, the written
       protocols of corporations that govern their behavior, laws, and rules written by
       government agencies.

       A practice is either the way a policy is carried out, or the way business is
       conducted in the absence of a defined policy. Practices are often the discretion
       of particular individuals and to change them will require finesse and negotiation.

At what level is this policy or practice set (federal, state, city, neighborhood,

       Federal level policy change generally requires substantial coalitions combined
       with connections in Washington, DC. However, this does not mean federal
       issues are not worth working on. It simply means that they are not easily
       affected from the local level. Media coverage can be a strong catalyst to
       changes in public policy at all levels, and is particularly useful for raising issue
       awareness nationally.

       State level policy change requires contacting state representatives. Statewide
       coalitions are very effective tools to affect state level policies and to strengthen
       understanding among activists and service providers across a range of issues,
       cultures, and geographies. If you are in a large city, which encompasses a large
       percentage of the state‟s population, you may be able to affect state policies
       simply by working with your locally elected state officials.

       Local policies, those set by county, city, or community authorities are changed
       more readily through local pressure than federal or state level policies. However,
       this does not mean that they will change readily. Many local policies are just as
       entrenched as federal policies, some more so. An examination of the
       stakeholders will help you decide if a policy is likely to change.

How many stakeholders are affected by this policy or practice? Who has a stake
in preserving this policy or practice?

       Making a list of stakeholders and defining their stake in the issue is helpful in
       many ways. First, this exercise will give you some idea of how readily
       changeable a policy is. If the list of people/institutions positively affected by the
       policy strongly outweighs (in number or power) the list of people/institutions
       damaged by this policy, you can conclude that it the issue will not be easily
       changed. Again, this does not mean it would be impossible to change: it means
       that the resource investment to affect change would be great.

       Secondly, your stakeholder list will help you define allies. These potential allies
       may surprise you. Don‟t be afraid to form coalitions with groups that you do not
       typically work with in order to affect change on a specific issue. Often
       policymakers are particularly impressed by such diverse coalitions. (The
       argument is that if traditionally „conservative‟ and „liberal‟ people can agree on an
       issue it must have real merit. In addition, the issue is perceived as playing to a
       broad spectrum of voters, donators, and supporters.)

       Thirdly, your stakeholder list should include an analysis of incentives. This
       analysis is a natural outgrowth of defining who gains and who loses from a
       particular policy. When you determine how an individual or institution gains or
       loses from the implementation of a policy, you have defined the incentives for
       that particular stakeholder.

Note: you may also find the worksheet “An Advocate's Guide to Prioritizing Policy Goals”
a useful tool when considering what policy or practice to target with the resources you
                        The Three Branches of Government

The state and federal governments, and usually local government, have three branches
of government, each of which may be an avenue for change on your issue. The
legislative branch, which includes the congress, state legislatures, and city councils,
makes the laws. This branch also collaborates with the executive branch to create the

The judicial branch, i.e. the court system, is responsible for interpreting the law. Judges
have the discretion to decide what the law means and their written decisions become
precedents that help to define future interpretations of the law. Additionally, judges are
responsible for determining which law takes precedence when two laws conflict, as in
the case of state sodomy laws recently overturned by the Supreme Court due to their
conflict with the constitutional right to privacy. As culture changes, the judicial branch
sets new precedents that overturn former precedents; it is a constantly evolving system.

The executive branch is responsible for enforcing the law. The executive branch
controls the military and the police, as well as a wide range of government agencies.
The government agencies that are responsible for health concerns from the federal level
Centers for Disease Control and Prevention to the city level health department are part
of the executive branch of government. For this reason the executive appoints the key
leadership positions in these agencies. For advocates working to affect health policy
developing relationships with executive appointees is useful for agency level change and
can help provide critical access to the executive and his or her thinking on an issue.

The executive has to sign every bill into law. If the executive vetoes a bill, generally a
2/3rds majority vote is required in the legislature to override the veto. Consequently,
both laws and budgets are the result of a negotiation between the legislative and
executive branches.
                              How a Bill Becomes a Law

In all three levels of government the executive (president, governor, and mayor)
proposes the initial budget which is then revised through various means by the
legislature and later signed by the executive to become the budget. As a result of this
process, the budget is a negotiation between the executive and legislative branches of


The United States Congress is made up of the 100 member Senate and the 435 voting
members of the House of Representatives. The Senate is made up of two
representatives from each state, regardless of the geographic or population size of the
state. The senate terms are six years with elections held every two years for roughly
one-third of the seats.

States are represented in the House of Representatives based upon their population.
Population is determined by the Census. Members are elected every two years. There
are no term limits in either house of the Congress.

Bill is Introduced
Members of Congress introduce bills as the first step toward making a law. Sometimes
these bills come out of a personal interest or expertise of the legislator or his or her staff.
Sometimes the bills are proposed by advocates or lobbyists (people paid to advocate on
behalf of groups – including corporations, labor unions, political organizations, and state
and foreign governments - who can afford to pay for people to advocate on their behalf).
A Member of Congress may even be given “draft legislation” to work with or introduce
unedited by an advocate or lobbyist. Another way bills are proposed is at the urging of
the President or one of the Executive Branch agencies; this is known as an “Executive

When a Member of Congress introduces a bill they become the named sponsor of the
bill. The bill receives a number with HR -for House of Representatives – or S – for
Senate – before it. (Ex. HR 126 or S123) All bills having to do with taxing or spending
(also known as appropriations) begin in the House. Once a bill is introduced it is sent to
a committee by the presiding officer.

Bill Goes Through Committee
The House has twenty standing committees, in addition to select committees and The
Committee of the Whole – the whole House convened to consider and amend bills but
not to vote on them. The Senate has sixteen standing committees, as well as select and
special committees, set up to deal with more specific or time-limited issues.
Committees are generally run by the member of the majority party with the most years of
service, known as the Chair. The member of the minority party is most often called the
Ranking Member. The members of the committees are in practice selected by the party
leadership. The committees have the power to hold hearings and subpoena testimony.
The committee members will debate the bill, and may even amend the bill, though their
amendments can be rejected once the bill is out of committee. The committee can
release the bill with a recommendation for passage; this is called, “reporting it out.” Or
the committee can hold on to the bill, which is called “tabling.” The chair manages the
work of the committee and therefore has a great deal of power over which bills are
considered quickly, over time, or not at all.

A bill may be referred to more than one committee if it deals with areas covered by
multiple committees. In this case one committee is designated as primary and the other
committees are generally given a time limit on how long they can consider the bill. The
primary committee has no time limit for consideration of the bill. A Member of Congress
may file a Motion to Discharge the bill from committee, if the bill has been in committee
for at least 30 days. A motion to discharge requires the support of a majority of
members to bring the bill to the floor for a vote.

Bill Goes to the Floor
A bill passes in both houses with a simple majority (51 in the Senate, 216 in the House).
In order for a bill to become law the exact same version of it must be passed by both
houses and then signed by the president. If two bills in the two houses need to be
resolved into one, a conference committee made up of members from both houses
works on creating a single bill for passage.

Bill Becomes a Law
When a bill arrives on the President's desk he may sign it, veto it, or wait ten days either
signing or vetoing it before sending it back to Congress. If Congress is in session when
the unsigned bill is returned it automatically becomes law as if it was signed. If
Congress is adjourned the return of the bill functions as a veto, this is called the “pocket
veto.” It takes a two thirds Majority of each chamber to override a veto.


The New York State Legislature was founded in 1777. Presently the Senate has XX
members and the Assembly xx. Both Assembly members and Senator are elected
every two years, the even calendar years. There are no term limits in either house of the
state legislature. The New York State Legislature has been widely criticized by good-
government groups for being undemocratic in its operations, and therefore for failing to
fairly represent the voters. While rules reform is currently underway, the process so far
is small. (For reference see the Brennan Center comparison of rules changes v. reform
recommendation provided in your packet.) In effect, the governor, the Assembly
Speaker, and the Senate Majority Leader decide which pieces of legislation are even
permitted to come to the floor for votes. This is the “three men in a room” system of
negotiation that you may have heard about.

Introducing a Bill
Ideas for bills at the state level originate in the same way federal bills do: from legislator
or staff interest or expertise; from constituents' needs, from executive request, from
advocates, from lobbyists. If the bill does not come to a legislators office in a legal
format (for example, some groups will hire lobbyists who have the legal expertise to draft
legislation), then the substantive ideas are sent to the staff of the non-partisan
Legislative Bill Drafting Commission, who draft the law or, more often than not, make the
appropriate amendments to existing law. This document, filled either with totally original
language or with the edited language of a change to existing law, is introduced in the
Senate or the Assembly, or sometimes both, if a simultaneous introduction has been
Bill Goes Through Committee
In both houses the bill is then assigned to a committee responsible for investigating the
merit of the bill and deciding whether or not the bill should go to the full Senate or
Assembly for consideration. The Assembly committees are more active than those of
the Senate. While both have the power to call for public hearings and request testimony,
the Assembly holds far more hearings than the Senate.

Bill Goes to the Floor
In practice a bill generally gets to the floor only with the permission of the Speaker in the
Assembly or the Majority Leader in the Senate. Non-controversial bills will be voted on
with no debate. Bills pass either house with a simple majority. If the bill passes one
house, it will be referred to the other house for a vote. If it is amended in the other
chamber, it must be reconsidered and re-voted on in its new form, before it can be sent
to the governor for signature or veto. As in the congress, both chambers of the state
legislature must pass a bill with the exact same language for it to go to the executive to
become law. If a bill needs to be reconciled the Speaker and the Majority Leader can
convene a conference committee, choosing which members from their house to serve.
This committee is charged with developing a compromise bill to be voted on in each

Bill Becomes Law
While the Legislature is in session, the Governor has 10 days (not counting Sundays) to
sign or veto bills passed by both houses. Signed bills become law; vetoed bills do not.
However, the Governor's failure to sign or veto a bill within the 10-day period means that
it becomes law automatically.

Vetoed bills are returned to the house that first passed them, together with a statement
of the reason for their disapproval. A vetoed bill can become law if two-thirds of the
members of each house vote to override the Governor's veto.

If a bill is sent to the Governor when the Legislature is out of session, the rules are a bit
different. At such times, the Governor has 30 days in which to make a decision, and
failure to act ("pocket veto") has the same effect as a veto.


The New York City Council is made up of xx members, currently dominated by

Legislative Process

1. A bill (proposed legislation) is filed by a Council Member with the Council Speaker's

2. The bill is then introduced into the Council during a Stated Meeting and referred to
the appropriate committee.

    A. One or more public committee hearings may be noticed and held on the
    proposed legislation.
    B. After public testimony and committee debate the bill may be amended.

    C. The committee votes on the final version of the bill.

    D. If passed in committee, the bill is sent to the full Council for more debate and a
    final vote.

3. If passed by an affirmative vote of a majority of all Council Members (at least 26
members) the bill is then sent to the Mayor, who also holds a public hearing.

4. The Mayor then chooses to sign or veto the bill.

    A. If the Mayor does sign the bill, it immediately becomes a local law and is entered
    into the City's Charter or Administrative Code. The time before a new law becomes
    effective will vary from law to law.

    B. If the Mayor disapproves/vetoes the bill, he or she must return it to the City Clerk
    with his or her objections to the Council by the next scheduled Stated Meeting.

    C. If the Mayor does not sign or veto the bill within 30 days after receiving it from
    the Council, it is considered approved automatically.

5. The Council then has 30 days to override the Mayoral veto. If the Council does
repass the bill by a vote of two-thirds of all Council Members (at least 34 members), it is
then considered adopted and becomes a local law.
Important Dates in the Budgeting Process

Mid-January – NYS Governor submits Executive Budget to legislature (and the public)

Mid - January – NYC Mayor releases Preliminary Budget by January 17th.

February – President of United States submits his budget to Congress (and the public)
on the 1st Monday in February.

February – Community Boards and Borough Boards respond to Mayor's Preliminary

February – mid-March – House and Senate pass initial Budget Resolutions, which do
not set binding spending limits, but do set a framework for budget negotiations.

March – City Council holds Budget Hearings

April 1st – NYS Budget due to be passed by Assembly and Senate and signed by the
Governor. Historically, this date was often ignored, but the last couple of years the
deadline has been met, in part, as a result of increasing public demand for on-time
budgets. April 1st is also the beginning of the fiscal year in New York State.

Late Spring-Early Fall – House and Senate sub-committees “mark-up” appropriation
bills. While holding hearings and gathering information, the committees draft and revise
the initial appropriations bills before sending them to the floor for votes.
May – City Council holds final Budget hearings taking into account Borough Presidents'

June – City Council adopts final budget by June 5th.

July – beginning of the fiscal year in NYC

Late July-September – City agencies and community boards develop budget priorities
for coming year, discuss with the Office of the Mayor. Community Boards hold hearings.

September – Mayor releases Mayor's Management Report detailing past year's
spending and performance for mayoral agencies.

October 1st – deadline for the passage of the Federal Budget. In recent years this
deadline has been missed requiring Congress to pass “continuing resolutions”, which
continue funding to the government using the past year's budget as a template for a
period of time. October 1st is also the beginning of the federal fiscal year.

Sources: The federal level is edited from Wikipedia listing on the federal legislative
process, “How our Laws are Made” published by the U.S. House of Representatives,
Updated 1997. The state level is edited from the NYS Senate website, as well as,
information from the Brennan Center for Justice. The city level is edited from the New
York City Council website.

For much more detailed information see:
“How Our Laws Are Made”

“How an Idea Becomes a Law”
“Unfinished Business: New York State Legislative Reform 2006 Update”

City Council Legislative Process
                    The Policy Target: Mapping Engagement

     Allies                                                                 Opposition





Directions: Make a list of the individuals and groups relevant to your cause. Place each
individual or group onto the policy target. Choose a regular interval at which to re-
assess your map. This can be a useful tool to both gauge your understanding of the
policy environment and the players in it, and to track your coalition building and
consciousness raising progress over time. Of course, in order to complete this exercise
you first need to be clear about your goal.The Policy Target Described
Allies and Opposition = Your allies and your opponents fall onto a spectrum. The
shading of the rings represents the intensity with which someone is allied with or
opposed to your point of view. For example, individuals falling into the grey portion of
the impacted ring will be very opposed to your recommendation for policy change. They
will have a strong incentive to preserve the status quo, as in the case of correction
officers opposing the downsizing of the jail, or a strong incentive to see a different
change implemented, as in the case of pro-life advocates who want to make abortion
illegal and pro-choice advocates who want to make abortion more accessible.

Targeted = The explicit subjects of the policy or practice (e.g. Mothers who work and are
prevented from pumping milk or breastfeeding their babies at work).

Impacted = People whose health or well-being is directly affected by the policy or
practice (e.g. Babies whose mothers wean them prematurely due to an inhospitable
work environment).

Invested = People who are not directly impacted by policy, but have a strong investment
in the outcomes caused by the policy. Often decision-makers will fall into this category,
because they may derive some benefit or harm from their association with the policy or

Interested = People who are not completely invested in the issue, but for political,
ethical, social, or spiritual reasons are interested in the outcomes of the policy. This
group may include residents concerned about an issue they are seeing in the
community, but from which they are personally distanced.

Uninformed and Unconcerned = People who don‟t know about the issue and people who
know about the issue but don‟t really care about it one way or another. You will note that
this ring is not shaded, because the individuals in it fail to support or oppose you in any
significant way.

Note: As an issue heats up more and more people will be drawn into the center rings,
both because awareness increases and because increased awareness changes
incentives. One of the important roles of the community organizer is to raise residents‟
awareness of the impact that a policy or practice is having on their lives and to illuminate
options for change.

If over time the map changes in unexpected or undesirable ways, it is time to re-evaluate

              Resource Assessment Guide for Advocates – Part 1
It is useful to think about policy change campaigns as investments. You need to weigh
this investment against other potential investments (i.e. servicing individual clients,
spending more time with your kids, etc.). What return are you hoping for on this
investment? What is the likelihood of that return?

Financial Capital = $$$$.

What dollars do you currently have available to put into your policy change campaign?

What other material resources do you have available that could be used in the

Infrastructure                                     Office Supplies
    9. Office Space
    10. Meeting Space for _____
    11. ____ Computers
    12. Internet Access
    13. Research Database Access
    14. Media contact lists
    15. Telephones
    16. Answering machines or
    17. White paper
    18. Colored paper
    19. Poster board
    20. Paint
    21. Photocopier
    22. Puppet-making materials
Human Capital = the work capacity of paid employees, volunteers, and coalition

Name                  % of time devoted     Employees,              Level of enthusiasm
                      to project            volunteers, coalition   for initiative       (1)
                                            members                 little----A lot (10)
                               Strategies for Advocacy

Developing an Advocacy Perspective
Whether you are working alone, with community members, lawyers, a coalition of
service providers, or other interested parties, you will need to create a story about the
policy you want to change. Understanding how the policy came about can be very
helpful. Having a history of the policy in your story can help lead the policymaker to
unDERSTAND why a policy which was once seen as needed is now outdated and
counter-productive. A description of how the policy is operating now is an essential
component of the story. Finally, you want to tell the policymaker a story of how things
could plausibly be different. Create optional alternative policies and describe the
intended outcomes of these changes.

The best stories will address the issues brought to the table by all the important
stakeholders in the policy. The most effective storytelling from a policymaker‟s
perspective includes both quantitative data (numbers of people affected by the policy
over time, some numerical representation of the problem with the policy, and, of course,
policy costs and benefits) as well as qualitative data (narratives that put the policy into
the context of real people‟s lives).

No matter what strategy you choose to affect change, an advocacy perspective is the
foundation of all productive change strategies. Advocacy requires that you share your
analysis of a problem with policymakers. This analysis should include recommendations
for change and explanations of these recommendations.


Communications have two important attributes: the quality of the information, and the
source from which it is coming. The quality of your information depends upon good
research and appropriate presentation. The way the information is received often
depends on where it came from, therefore consider who you are communicating with.
Would they respond best to a type of person (constituent, professional, scientist) or
group (local, professional, large), or a specific person or group that they perhaps know
or have a history with?

Choosing a strategy or combination of strategies requires that you define your goal
clearly. Once you have chosen the policy you want to change or mitigate, you can set a
change goal. What outcome are you looking for? The various strategies for change
have both productive and unhelpful side effects. Keeping your goal in mind will help to
guide you to the strategies most likely to produce positive change in both the short and
 Coalition Building – Working with existing organizations and individuals outside
    of your primary coalition can help create momentum for change. Are there other
    groups interested in or working on the same issue? If so, advocacy work can be
    much more powerful when backed by a large, diverse coalition. You will find both
    natural allies, i.e. people who support your effort for change and share your
    motivations, and unnatural allies, i.e. people who support your effort for change and
    are motivated to do so by incentives that you do not share. Even natural allies will
   have a larger set of goals, all of which you may not share. While it is important to
   keep the coalition on topic, it is equally important to support coalition members on
   other issues that they are concerned about when possible. If the partnership is
   working with unnatural allies, it may be more difficult to support them in their other
   work. Therefore, The partnership should think about other ways to show
   appreciation for their share in the coalition work.

   When thinking about the logistics – the grunt work – of coalition building, the focus
   should be on communication. Regular face-to-face meetings compliment email and
   phone communication. Full coalition meetings need not be frequent, but they should
   happen at regularly scheduled intervals. Additionally, small subcommittees can be
   useful to move specific strategies forward.

          Community Organizing – Working with community members, outside of
  a coalition, also creates momentum for change. Particularly if the community
  members are motivated to take a strong and sustained interest in the issue at hand.
  This strategy has the advantage of building real local power, creating an informed
  base of community members, creating leadership at the community level, and
  creating a foundation for long-term change across multiple issues. However, this
  strategy requires the sustained attention of organizers and a long-term investment in
  the community, which may not yield immediate results, and may not yield the
  projected outcomes (or the outcomes required by funders if it is a funded initiative).
  Additionally, this strategy can fail to be effective if the community being organized is
  so marginalized that policy makers can easily ignore them. In this case coalition
  building, media strategies, and/or lawsuits may be used in tandem with local
  organizing efforts.

 Lawsuits – Lawsuits force a discussion of an issue. They tend to gain media
  attention. As the anti-tobacco suits illustrate, lawsuits can legitimize a struggle for
  change in an area. However, lawsuits are extremely expensive and require lawyers.
  Additionally, engaging the legal system and failing can have serious long-term
  implications. If a judgment is found in favor of the defendant (the city agency,
  government office, etc. in which the partnership is trying to affect change), the
  precedent of the case may be used to further promote the status quo, and to legally
  block change in the future.

   Court rulings can affect policy and practice both directly and indirectly. In some
   cases court rulings explicitly require a change in policy or practice. For example, in
   New York City a class action lawsuit was brought against the city on behalf of jail
   inmates with mental health diagnoses charging that the city was violating the law in
   failing to provide discharge planning for them. This lawsuit has resulted in a
   dramatic increase in discharge planning for this population.

   If a court ruling does not specifically require a change in policy, it may still change
   the incentives for stakeholders in a way that encourages policy change. For
   example, over the years in NYC several high profile police brutality cases have
   resulted in changes in police procedure. (OK, one has to admit that these changes
   often seem temporary, but they are not unimportant.) The civil lawsuits in these
   cases sought monetary awards for individual claimants and the judgments resulted in
   high costs for the police department that increased the incentive to change policy.
    Both civil and criminal cases have the potential to influence the policies and practice
    that impact health in the community. Criminal cases are initiated by a government
    prosecutor. In order to initiate a criminal case an advocate or coalition would need to
    convince a district attorney to prosecute. District attorneys are elected and will
    therefore be likely to stay away from controversial issues. However, advocating for
    criminal prosecution can be very effective in cases of fraud or endangerment: for
    example, when an organization with a government contract is failing to provide
    services to clients or is abusing clients. Civil cases are initiated by a private attorney
    on behalf on an individual or class of individuals. Civil cases can seek monetary
    damages, changes in policy or practice, or both. Class action cases seek
    reparations in civil court for an entire class of defendants, represented by a few

 Negotiations – Face-to-face negotiations can help to build trust between
  stakeholders, can broaden the perspective of stakeholders, and can expand the
  range of change strategies. Negotiations can also go bad. Face-to-face
  negotiations that go bad can leave people with negative feelings about the issue or
  about working with coalitions. A thorough analysis of stakeholders‟ incentives for
  change and their incentives for participation in negotiations will help to determine if
  negotiating is a viable option. The incentives for policymakers to negotiate will be
  influenced by other change strategies, such as lawsuits, media attention, or
  community organization. If people can be brought to the table with some chance of
  progress or resolution, the next step is to find a skilled facilitator, who will be
  accepted by all the participants. In order to predict your chance of success try to
  imagine what each of the stakeholders will do in the absence of a negotiated

    For coalitions the challenge of negotiated agreements is to appoint a negotiator for
    the group. In some cases, all the members of the coalition can be present at a face-
    to-face negotiation. However, even in this situation it is critical both that the partners
    have defined their values and their goals so that they can provide a unified front, and
    that they have a clear enough understanding of their shared broad goals to avoid
    getting into position bargaining (in which the negotiators get stuck on a specific item
    and lose track of the greater potential good).

    City, state, or federal agencies with appointed leaders may have policies that can be
    affected through direct negotiations in combination with other strategies. Appointed
    officials may be more interested in cost-effectiveness or program or policy efficacy
    than the concerns of voters. For this reason, researchers are a useful liaison to
    appointed officials. The appointed official will be most closely concerned with the
    positions of their appointer (mayor, governor, or president), therefore negotiating with
    appointers is another avenue for change. In most cases it is useful to start lower on
    the hierarchical ladder, beginning with agency staff, and work your way up.
    Remember, if you go directly to the appointer a “no” will generally mean “no” from
    everyone who works for them as well. If you work from the bottom up, convincing
    people as you go, you may be able to build support for the change within

 Legislative advocacy - Approaching elected officials directly can be very
  effective, if they have the authority to change the targeted policy. You can contact
  the legislator through their local district office or in their legislative office (at city hall,
   in Albany, or in Washington). You can make an appointment to see the legislator or
   a staff member. Several things work together to impress legislators: the support of a
   large number of voters in their district, the support of other respected elected
   officials, the support of a few important or wealthy individuals (especially campaign
   contributors) in the district, compelling facts, compelling arguments, compelling
   stories. To find out who your local legislator is you can call your local League of
   Women Voters, or check them out on the Internet ( 501c3
   designated tax-exempt organizations need to be very careful about lobbying for
   specific legislation, but have the freedom to educate elected officials.

          Run for Office – In an election year, running a candidate from the
  community can be a great strategy. If the candidate wins, she was pre-selected to
  care about your issue and work with you. If they merely raise the level of awareness
  of your issue through debate and media attention, that is also a victory. (Remember
  Al Sharpton in the 2004 democratic debates?) Recently an New York State
  Assembly set opened up and my colleagues and I convinced Susan Chamlin, author
  of Senator Krueger's Breastfeeding Bill of Rights legislation, to run. If she wins we
  will have an incredible ally in the Assembly, if she loses we will have gotten many
  free media hits on the topic of breastfeeding.

   If you don't have a candidate to run, find out who is supporting your issue (by calling
   the candidates) and work to get your supporter elected. If none of the candidates
   seem to know or care about your issue that is a great opportunity to educate a group
   of people, one of whom will soon be a decision-maker.

        Public Education Campaigns – Successful public education campaigns
  reach a targeted audience with a message that is persuasive to them. For this
  reason, defining the audience for the campaign is an essential first step. For
  example, providing information about infant safely to new parents, or informing
  Medicaid recipients about proposed changes in Medicaid. Public education
  campaigns can seek to educate people to change their personal behavior, or inspire
  people to get involved in changing policy.

   Media contacts, while they enhance public education campaigns, are not essential.
   The key is to design a public education effort that fits both your topic and the
   resources available to you. If your subject is off of the policymaker/media radar,
   grassroots education -- using art, chalk tagging, flyers, and events -- can be effective
   strategies to spark public interest. Community residents are likely to be able to
   identify opinion leaders – influential people - in the community. Convincing an
   opinion leader of your position is one of the most effective forms of grassroots public
   education. Information sharing is the first step to the creation of allies that may one
   day be able to put your agenda on the public stage. To this end, speaking and
   networking at block association meetings, tenants association meetings, church
   functions, and tabling at street fairs can help your coalition to get the word out.

 Rallies and Public Demonstrations – A public display of approval or dissent
  can be exciting for the participants and memorable for the observers. On the other
  hand, in today‟s political climate it is also potentially physically dangerous, and may
  not be covered or favorably covered by the media. These events are made more
  powerful by strength in numbers and clarity of message.
 Media Strategies- A media campaign can enhance an ongoing public education
  campaign or turn a demonstration into a public education event. Media Campaigns
  attempt to directly affect media coverage of an issue, through press releases, media
  invited events, op-ed pieces, articles, and paid or unpaid advertising. Media outlets
  are found in print, on television and radio, and on the internet. Local media,
  community newspapers, and independent media will often cover local issues and
  controversial issues when mainstream national media will not.

 Documentary: Photo, Film, and Print – Documenting the work of your coalition
  as it pursues a change strategy provides a useful historical record. Additionally,
  articles, photos, and films about the coalition or the issue of concern can be a useful
  jumping off point for a public education or media campaign.

           Study Circles and Consciousness Raising Sessions – This grassroots
  organizing technique was very popular in the 60's and 70's. Today some internet
  coalitions like use this tactic to bring their members face-to-face. The
  strategy is to bring small groups of people together to learn about and discuss an
  issue. It has several advantages 1) it typically is below the radar of government
  observation; 2) it builds real relationships between individuals; and 3) it encourages
  critical examination of the issue and problem solving.

         Special Arrangements - One way to achieve immediate results is to
  negotiate special arrangements to mitigate the negative impact of policies on
  community residents. Maybe the city, state, or federal government isn‟t ready to
  recognize a living wage as a human right, but a coalition still may be able to
  negotiate living wage policies at a large local employer, like a university. A special
  arrangement is a change in practice that can sometimes build momentum for a
  change in policy.

          Pilot Programs –A pilot program can be initiated one of two ways. A
  coalition can go directly to the authority in question and ask to start a pilot program in
  which community residents would be given a needed service or exempted from a
  prohibitive regulation. Another strategy is to develop a community-based program
  that addresses community needs locally.


If you have a lot of resources… think big. Brainstorm with affected stakeholders.
When you have decided on your issue, you may decide to pursue multiple change
strategies in order to build momentum for change. Play to win. Having resources
means that you will probably have more ability to get and sustain the attention of the
public and policymakers. Be prepared to set the agenda. Think about devoting some of
your resources to developing a very detailed new policy (i.e. your ideals enacted in the
context of the current political and economic realities). If you offer a plausible alternative
to current practice, policymakers will be more likely to listen to you.

If you have very limited resources… pick a change strategy that will allow the
coalition to make the best of what it has and will increase the resources for change in the
future i.e. social networks, media contacts, or your knowledge about the policy. Choose
a policy that is likely to change. It is particularly important for coalitions that have slim
resources to have early victories in the policy arena. Member morale and enthusiasm
will be boosted by early success. Success may also lead to additional funding or other
types of resources. If the coalition has chosen to work on a difficult policy, build in the
expectation that victories will not come quickly and focus on relationship and capacity
building. Many policies take a sustained effort over a long period of time to change.

If the policy affects only a very marginalized group… be clear about what is at
stake. Working to change public policy can be a very empowering experience for the
affected individuals. However, keep in mind that while it may seem that a person who is
being harmed by a policy has little to lose in trying to change it, a defeat can be another
blow to an already fragile individual or social network. Sometimes the individual or
network will bounce back stronger or more cohesive and ready to try another strategy;
sometimes an early defeat will discourage further activity.

If the practice is in conflict with an existing law or regulation…consider face-to-face
negotiation as a first step, keeping in mind that the alternative to a negotiated agreement
is always to try a media campaign or a lawsuit. Look to the list of stakeholders and their
incentives to discover why the discrepancy exists. They key in this situation is to change
the incentive for the stakeholder who is not practicing the policy. Approach the
negotiation as cooperatively as possible. The mere fact that the practice is in conflict
with the law will create an implicit threat. If you approach the situation in an adversarial
manner it may escalate unnecessarily. Remember, community residents will have to
work within these systems and with the individuals who operate them for a very long

If the policy or practice targets very few people… think about the incentives that
other people have for caring about the issue. For instance, many people who are not
directly involved in the criminal justice system do not give it a second thought, until they
find out how much tax money is being spent for poor results, such as high recidivism
rates and high rates of communicable diseases. If you think about the impact on society
of the partnership‟s concern, you can often develop a wider base of support. However,
for really dedicated support look to the families and friends of affected individuals (the
impacted on the policy target).

If you are looking to affect a permanent change… focus on the incentives inherent in
the system. The change you affect will only last as long as the incentives in the system
remain aligned with the policy. Long-lived policies are created with in a system in which
many stakeholders are given an incentive to support the policy. For instance, Social
Security has become a sacred cow in the United States, because virtually all individuals
(rich and poor) in America expect to benefit from it when they are older.

If you want a quick fix to a short-term or emergent problem… negotiating a special
arrangement may be your best course of action. Special arrangements don‟t typically
require a large investment and can change immediately the experience of targeted

If your day has come… Once in a long while the coalition may find that their issue
becomes sexy. The media is interested, lawmakers are interested, etc. Sounds like an
ideal situation? It can be. The key is to turn interest into action. To do this the coalition
needs to keep its plan (recommendations, draft legislation, press releases) at the ready,
a plan backed by stories and numbers, and relationships.
                                 Media Tips for Advocates

Excerpted from: “Headlines and health: how to work with the media” a panel discussion at the
American Public Health Association's 2003 Annual Meeting, featuring: Susan Fitzgerald medical
writer for the Philadelphia Inquirer; Bill Fantini, News Director WHYY, NPR affiliate; Doug Gruse,
editor, Philadelphia Gay News; Marion Uhlman, medical writer

If you are going to be in touch with the media you are going to have to do your
homework. Newsrooms are understaffed and may have poor infrastructure. It is your
responsibility to contact the right person.

Most reporters and editors may be willing to take the time to sit down with you to be
educated about an issue in the community. However, you must be really clear about
your agenda. One of the biggest problems with organizations is that they are very
myopic (short-sighted/self-focused) and have trouble describing an issue beyond their
organization's experience.

Competition for your message with all other worthy causes, and great organizations.
You can assume that if you are doing good deeds and serving a worthy cause, NPR or
other non-profits may want to cover it. It doesn‟t mean they will.

Practical issues:

       responsiveness to deadlines of journalists. If you are available right away you
        are more likely to be used.

       How does your contact want to receive your press release. (email, mail, fax)?

       The same media outlet may have several different outlets that should be
        contacted about different angles to your story.

       Make concise pitch at the top of the press release (Could be that the who is the
        most important thing to plug, sometimes it is the concept, sometimes the info).
        More info will follow.

       Better to have someone who is doing the thing contact the news, rather than a
        PR person.

       Reporters and editors world view does influence what they write on and publish
        and the level of priority assigned those studies, therefore it is important to know
        something about the media outlets that you are submitting your stories to.

       Confidentiality issues can get in the way of agencies putting names of people
        forward to connect people with stories. So it is important to develop a stable of
        people willing to speak on your issue, preferably in advance of any major media
To increase likelihood of coverage for your story:

   24. target your issue to the audience of the media outlet.

   25. weekends can be a good time for non-profit stories, because the newswires
       cover mostly death and accidents.

   26. if you are offering experts, available to talk on a given topic, make sure that your
       expert is able to speak articulately to the public.

   27. ask broadcast facilities if they run public service announcements and find out
       where you should direct them.

   28. don‟t assume that if you call a press conference that the press will show up. If
       you call it make sure there is some news to give out.

   29. proximity (regionally important)

   30. celebrity involvement

   31. universality of topic – interests a lot of different kinds of people

   32. personal impact on media consumers

   33. become familiar with the writing of the reporter you are contacting. Refer to their
       work in your communication.

   34. send a directory of staff/advocates/community members listing their expertise to
       newsroom (when a story is in the news and likely to stay in the news or for their

pitching to a niche market – small, community-based (either identity or geography)
newspapers and magazines

          small staff, so not a lot of time to sift through press releases, but may be
     more available to develop an ongoing relationship with, if your issue is closely
     related to their paper's community.

           sending a blind press release probably won‟t get coverage.

    5 seconds, if can‟t figure out what the story is in 5 seconds it will get

                 hand write at the top why it is important to the niche newspaper.

           try a follow-up phone call.
How important is the human angle?
Depends on nature of the story: hard news v. feature angle. A story that has been
covered a lot but has missed individual angle may be covered from that angle. But new
information, experts are important.

How to turn important messages into stories?
   stories that wrap a pubic health message around and individual or communities

      news events (rise in diabetes) multiple stories follows.

      stories that lose. stories that are around all the time. find really interesting
       people, maybe in the trenches working on the issue.

      find an engaging personality to front your issue.

      since news has become so radicalized (man bites dogs) more traditional stories
       are now kind of interesting or surprising.

The role of the op-ed pieces:

      letters to the editor may be published expressing a different view from a
       published piece. In this medium you may be able to really quickly make a point.

      reputation of people sending letters greatly impacts whether or not it will be
       published – elected officials, agency directors, experts in the professional field,
       people personally affected by the issue are all compelling authors. Just because
       you write it doesn‟t mean it will get published. Criteria: really topical and from the

      Have to send these the day of, or week of (for a weekly publication) relevant

Do media outlets have a social agenda?
    some reporters develop an interest in one issue and some expertise and want to
     do a series of stories.

      the job is not to set the social/political agenda

      if the weight of the topic is such that it merits ongoing coverage.

      if the story has legs (i.e. staying power) then the reporter will want to write
       stories from many different angles over time.
Many papers have their own photographers and don‟t use submitted photos. Smaller
publications will accept photos, but not of some event that happened last week. A head
shot of expert you are recommending they speak with is useful. If you send a photo be
sure it is a high resolution image.

Is it harder to get coverage of mental health issues?
It is a challenging beat with a big range of stories. Typically there are confidentiality
issues, because of stigma. Also because some outlets have rules that reporters must
use the real names of people.
                           Legislative Meeting Checklist

Before the Meeting:

      Identify what you are asking for and/or what pieces of information you want to
       share with your legislator. (The ask is important – legislators want to know what
       it is you want from them.)
      Research the legislative record of your legislator. Do they support your issue,
       oppose it, or have no record?
      Gather a team for the visit including: constituents, experts, community leaders.
       Five is a good maximum for a group.
      Train the team. Decide who will speak on what topic. Try some role plays. Try
       to anticipate what questions the legislator might have for your team.
      Call the legislators scheduler and request a meeting. Tell them who you are,
       where you are calling from, who you represent, and what the topic of your
       meeting will be.
      Be prepared to speak about the topic for 30 minutes if the person is very
       interested. Be prepared to explain your issue persuasively in 5 minutes. That
       might be all the time you get.

To Do at the Meeting:

          Be on time. It is an obvious one, but if you over schedule meetings it
     might be hard to achieve, so leave yourself ample time.
    Introduce everyone in your group to the person you are meeting with. Be
     sure to identify any constituents you have with you. Be sure to explain how many
     people/organizations you represent, if you represent a coalition or membership
    If you are meeting with a staff person rather than the legislator, take that
     meeting just as seriously.
               Give the legislator written materials that cover in more depth the
     issues and information you will talk about with them.
    After providing the information you are there to give, ask the legislator
     where they are on the issue, ask if they have any questions, concerns, or need
     any other information to make a decision.

Follow Up After the Meeting:

   35. Thank you note to legislator and staff you met with.
   36. Information requested by the legislator.
   37. If you meet with the legislative office, contact the district office staff as well to
       offer your group as a resource on the issue.
   38. Invite your legislator to events in your community and/or on your topic of interest.
   39. Keep track of your legislator‟s actions on your issue.
   40. If your legislator does something for you on your issue, be sure to publicly praise
       them, perhaps giving them an award (unless for some reason it would hurt your
       legislator politically, then just send them a private thank you).
                             Why Do Advocacy Work?

For Community Members
   41. Understanding the systems that impact the health and well-being of you and your
       family can inform your personal choices – the ones immediately in your control –
       and help you and your family to be healthier.
   42. Advocating for change can be an empowering and enriching experience. You
       can gain skills that you may use in a work setting; you may meet people who will
       become good friends, important allies, or networks to jobs or other opportunities.
   43. If you achieve your advocacy goal, obviously that will be very satisfying and
       change your life for the better.

When working on an issue of importance to you and your family consider the following
     Working within the existing challenges focusing on you and/or your family
       to make the changes in your lives that would benefit you. (Example: The fitness
       challenge – family members compete to see who can do three sessions of
       exercise per week, losers do household chores.)
     Take a community level approach to working around structural
       challenges. (Example: There is no community center in the neighborhood, so the
       parents organize rotating playtimes at each other‟s houses for their children.)
                Work in coalition to make changes to policy and practice that will
       improve your life and others in your geographic area or community of identity.
       (Example: Parents in a community with limited park space advocate for
       increased parks and a community center, citing local health statistics as well as
       citywide funding for such initiatives.)

For Service Providers
    Understanding policy barriers can contribute to a client centered viewpoint, as
       you will better understand the structural challenges faced by the client.
    Advocating for change will help you to increase your skills that can be used in a
       work setting.
    The networking involved in coalition building for change is also often useful in
       identifying clients or growing a service agency in other ways, for example
    Working on policy barriers can improve life for many clients and potential clients
       at once. Case managers understand structural barriers better than most people,
       because they see client after client who have the same problem even though
       they are different in other ways.

When deciding how to work on a structural barrier consider three options
   Working with the client to work around the existing barrier (i.e. calling an agency
      to advocate for the client, going with the client to an agency to get service.)
   Working with an agency to improve service for or treatment of a group of your
      clients (making a special arrangement with an agency to allow clients you serve
      to get some kind of special treatment.)
   Working with the system to change policy or practice for all people who are like
      your clients (through advocacy, negotiations, changes in laws, and lawsuits to
      change regulations or practices.)
In order to make your decision, weigh the time and effort against the rewards of action.
To convince your boss that you should take time away from casework for policy work
and advocacy, explain the goal of changing the situation for many clients at once. If you
work in coalition, a small amount of your time and your agencies commitment can get

Please feel free to us me as a resource in your future endeavors.
Cassandra Ritas
                               References for Advocates

Dial 311 – NYC's portal to city government agencies, can help you identify your elected
representatives and get their contact information. Also a great way to file
complaints/comments on a surprisingly wide range of community concerns/conditions.
Project Vote Smart includes: find your legislator, voting records, and special interest
group ratings of legislators.

Government Websites
The official website of the President of the United States.
The Office and Management and Budget where you can find the proposed executive
budget and other federal fiscal highlights.
The Library of Congress provides free online information about activity in Congress.
New York State Senate website includes: bill search, senate and hearing schedules,
senator profiles, rules, press releases, and live streaming coverage of senate in session.
New York Assembly website includes: find your legislator, bill search, assembly and
hearing schedules, assembly member profiles, reports, rules, press releases, and live
streaming coverage of the assembly in session.
New York State Division of the Budget website includes all budget documents as they
are published an made publicly available, including preliminary budget documents. A
really great place to find out what the upcoming budget looks like before you go to meet
with an elected official.
The website of the New York City Council. Includes find your member directory.

New York Political Blogs
The edited blog by the NY observer filled with local political scuttlebutt.
The edited blog by the Daily News, covers national as well as local politics.
The blog of the Albany Times Union – Capital Confidential.
Another New York State political blog that all the staffers read, and many of the elected
contribute to.
Policy Research Institutions:

Center on Budget and Policy Priorities                    


Drum Major Institute

Fiscal Policy Institute

Institute for Policy Studies                              

Local Libraries with computers for public use:

2900 Broadway [at W. 113th St.], New York, NY 10025-7822. 
 (212) 864-2530
203 West 115th Street, New York, NY 10026-2403. (212) 666-9393
9 West 124th Street, New York, NY 10027-5699. 
 (212) 348-5620
224 East 125th Street [near Third Ave.], New York, NY 10035-1786. 
 (212) 534-505
518 West 125th Street [at Amsterdam Ave.], New York, NY 10027-3407. (212) 662-
104 West 136th Street [near Lenox Ave.], New York, NY 10030-2695. 
 Call us at
(212) 491-2070
503 West 145th Street, New York, NY 10031-5101. 
 Call us at (212) 926-2147

The New York Public library also offers free computer and research classes with limited
spaces available. Call your local branch, or look on the internet for a schedule.

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