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Message from Bob Doherty and Shuan Tomlinson

Welcome to Leadership Day 2018, the College’s annual two-day advocacy event held in Washington, D.C. that enables ACP to increase its presence on Capitol Hill and bring our issues of concern to U.S. lawmakers. We have an exciting program and experience in store for you, including many educational briefings on the key policies you will be discussing with lawmakers as well as an opportunity for you to socialize with your colleagues. The event will be held at the Mandarin Oriental Hotel in Washington, DC, again this year, which is a short metro ride or taxi ride to Congressional offices.

ACP’S Advocacy Agenda

Knowing Where We Have Been:  “Those who do not remember the past are doomed to repeat it." This quote, from Spanish writer George Santanya, reminds us of the importance of taking stock of the past, acknowledging both the challenges and opportunities we faced and how we addressed them, and allowing that to inform our decision-making going forward.  That too holds true in advocacy.

Years following a presidential election, especially when control of the White House and/or Congress switches from one party to another, poses special opportunities and challenges for advocacy organizations like ACP.  This was true when President Obama was elected in 2008, and President Trump was elected in 2016.  New presidents bring with them their own agendas, priorities and initiatives, and when they are dramatically different than those of the prior administration’s, ACP must be nimble in responding to and influencing the changed circumstances.

In 2017, we faced considerable change in the political environment when President Trump offered very different policy priorities than the previous administration, and with a GOP-led Congress that felt emboldened in trying to push through sweeping reforms to our health care system, some of which were in conflict with ACP policies, while others we supported.  On top of that grew a political divisiveness within the country that created an impediment to getting things done.  That was our reality and it impacted our advocacy agenda in significant ways, including our 2017 Leadership Day priorities.

Yet, despite these challenges, and due to your continued advocacy, grassroots mobilization, coalition-building, and countless campaigns, we succeeded in achieving substantial “wins” on the vast majority of our 2017 priorities. That included: beating back multiple attempts by Congress to repeal health coverage, patient protections, and essential benefits under current law, improving payment for internists’ services, reducing administrative burdens on physicians, increasing funding for key programs that support the physician workforce and the public health, and advancing reforms in chronic care management.  The majority of these policy achievements enjoyed bipartisan support, not only from our membership but from within Congress as well, as part of ACP’s forward-looking health care agenda.

What Lies Ahead in 2018:  As we now focus our attention on 2018 and Leadership Day in May, we want to build on the progress made in 2017 but also add new policy objectives that are ripe for congressional action in the current political environment. Assessing that political landscape serves as a key factor in our determining which ACP priorities have a viable chance for advancement or success in a given year.  We have limited “bites at the apple” in advocating before Congress, which means that we often have to be selective with our Leadership Day priorities, which is not to discount the many other priorities we do have and for which we continue to advocate throughout the year.

We learned last year that Congress does not appear to have the votes to pass legislation to systematically dismantle current-law health coverage, protections, and benefits – although some of that effort has shifted to the states in trying to undermine the law -- which means that Congress now must confront an ailing individual health insurance marketplace, rising premiums, and millions who still need affordable coverage.  Likewise, while progress has been made in addressing the opioid epidemic raging across the country, more needs to be done, especially since many of the programs created by the ACP-supported bipartisan Comprehensive Addiction and Recovery Act (CARA) of 2016 will lapse unless reauthorized and funded by Congress. 

Congress has done little to rein in prescription drug costs, although several ACP-supported bills have been introduced; we need you to help us build support for those bills in your Leadership Day visits.  While we are encouraged by the Trump administration’s and Congress’ interest in reducing excessive administrative burdens imposed on physicians and their patients, and with improvements that have already been made in large part because of ACP advocacy, we need to convey to lawmakers the urgency of doing more to put Patients Before Paperwork.  We need to ensure adequate funding for key federal programs that support the critical pipeline of new physicians.

Finally, in the wake of several devastating mass shootings this year, and the more than 120,000 each year who are killed or injured by firearms, we are seeing more willingness from many members of Congress to consider bipartisan steps to reduce firearms-related injury and death.

Conventional wisdom is that Congress does not pass major legislation in a mid-term election year.  While this may be true overall, Congress must fund the federal government and reauthorize programs set to expire.  This creates opportunities for us to see progress on the priority issues for Leadership Day 2018, listed below.

While not all of these priorities will necessarily result in major legislation this year, this by no means indicates that there is no point in pushing them in your visits with Congress.  One lesson from the past is that successful advocacy can’t be just a one-or-two day effort that magically brings immediate results; rather, it takes months and sometimes years of sustained advocacy, coalition-building, and persistence.  The seeds you plant during Leadership Day 2018 will help us achieve future victories on our priority issues.

Key Policy Issues for Leadership Day

• Expand Coverage and Stabilize the Insurance Market: Stabilize the insurance market, cover more people, and protect Medicaid to ensure greater access to care.
• Reduce Administrative Burdens: Reduce the growing number of administrative burdens associated with EHR interoperability and usability, clinical documentation requirements, and prior authorization.
• Reduce Prescription Drugs Costs: Address the high cost of prescription drugs through greater pricing transparency and elimination of anti-competitive industry practices that keep lower cost drugs off the market.
• Address the Opioid Use Epidemic: Reduce barriers to integrating behavioral health into primary care and address the related rising death toll from opioid use; reauthorize and fund the opioid prevention and treatment programs created by the Comprehensive Addiction and Recovery Act (CARA).  
• Ensure Sufficient Funding for Medical and Health Services Research, and Primary Care Training Programs: Ensure necessary funding for the National Health Service Corps, Title VII Health Professions, the Agency for Healthcare Research and Quality, and other public health programs.
• Reduce Firearms-Related Injury and Death: Pass meaningful legislation to strengthen the criminal background check system, ban assault weapons and high capacity magazines, and remove federal research restrictions on firearms-related injuries and death.
• Support Graduate Medical Education (GME): Reform GME to prioritize and ensure sufficient funding toward physician specialties facing shortages, including primary care internal medicine.

The Role of Chapters and ACP Members

The involvement of our chapters and our ACP Advocates is a vital component to the effectiveness of our advocacy efforts, and that includes your participation in Leadership Day.  This event is our most critical advocacy event of the year, providing you the opportunity to learn about and advocate for ACP’s health care priorities, have valuable face-to-face time with members of Congress, and most importantly provide the clinician perspective on how policies being contemplated by Congress impact your patients. Your voice and your involvement, as constituents, in the legislative process can make all the difference in whether your lawmakers support or oppose a given policy reform. As always, we appreciate the time that you take away from your practice, your patients, and your family to be here in Washington advocating with us for the greater good.    

Leadership Program and Logistics

The official Leadership Day program will begin Tuesday, May 22 at 12:45 PM with opening remarks from key College leaders followed by in-depth issue briefings by congressional and Administration staff.  Attendees will hear from a host of Washington insiders who will provide their insights on the current political environment and its impact on ACP’s issues.

An optional grassroots advocacy training session will be offered on Tuesday morning, May 22, at 10:30 AM to help our first-time attendees prepare for their Hill visits.  This session is also helpful for those looking for a refresher on what to expect in their congressional meetings. The training will be interactive, lively and well worth the time commitment.  

A special briefing for medical students and residents/fellows in-training will be held again this year at 8:30 AM on Tuesday, May 22, at the Mandarin Oriental Hotel.

The registration desk will be open on Tuesday morning, May 22, at 8:00 AM for attendees to pick up briefing packets and name badges. On Tuesday, a light lunch will also be provided for all participants.

As for evening activities on Tuesday, May 22, there will be two receptions held early that evening, one exclusively for current members of the ACP Services PAC and another for medical students and residents/fellows in-training. There will be no formal dinner that evening;  allowing attendees to enjoy dinner on their own in Washington or gathering with their chapters to coordinate for the following day’s congressional meetings. A list of nearby restaurants including relatively inexpensive ones is provided and available on the Leadership Day webpage.

We will start our Capitol Hill Day, Wednesday, May 23 at 7:00 AM at the Mandarin Oriental Hotel with breakfast, key announcements, and presentations from key lawmakers. Andy Slavitt, former Acting Administrator of the Centers for Medicare and Medicaid Services, will be presented with ACP’s 2018 distinguished Joseph F. Boyle Award at 8:15 AM. We encourage all chapters to arrive promptly at 7:00 AM that morning to hear the full line up of speakers, including Mr. Slavitt, and to schedule their congressional meetings no earlier than 9:30 AM so you can remain on site to hear his full remarks.   Immediately following, attendees will disperse to their scheduled congressional appointments on Capitol Hill. Please note that the Mandarin Oriental Hotel is a short taxi cab or metro ride away from Capitol Hill and attendees are responsible for those transportation costs. A hospitality/debriefing room on Capitol Hill (HC-8 in the Capitol – House side) will be available throughout the day on May 23 for attendees, starting at 9:30 AM.  This room is available to attendees to allow them to rest between their meetings, have a snack, and otherwise compare notes with their chapter delegation members.

Leadership Day Registration: The Leadership Day online registration form is available on the Leadership Day webpage. Please note the deadline for registration is April 30 and chapter governors must register themselves for the event.  ACP National does not automatically register its officers.

Hotel: A room block has been designated for Leadership Day attendees at the Mandarin Oriental Hotel, Washington, DC at the discounted rate of $357 per night. Our room block is filling up quickly so if you have not made your reservations, please do so quickly.  If you are unable to acquire a room in our block, please contact Shuan Tomlinson at stomlinson@acponline.org. Hotel reservations can be made online. Please ask for “ACP’s Leadership Day” event if you are phoning in your reservation. The deadline to make hotel reservations is Monday, April 30.

As you may be aware, three major airports service the Washington D.C. area, Ronald Reagan National Airport, Dulles International Airport, and the Baltimore-Washington International Airport (BWI).  You may find substantial savings with flights into BWI. While the trip from BWI to downtown Washington is longer than the trip from Ronald Reagan National Airport, limousine/shuttle service is available.  BWI is only a few miles farther from downtown Washington than Dulles Airport. During weekday travel, MARC trains make frequent trips from the BWI airport to Washington’s Union Station (one-way ticket starts at $11).  A free shuttle is available for the 5-minute ride from the BWI Airport, baggage claim level to the BWI rail station.  Go to: http://www.bwiairport.com/en/travel/ground-transportation/trans/marc for more information and the MARC Penn Line train schedule.

Arranging Your Chapter’s Hill Meetings for Wednesday, May 23:  For those chapters that are scheduling their own congressional meetings, contact information for U.S. Senators and U.S. House Members is available online on http://cqrcengage.com/acplac/app/lookup?4&m=13814 – (pocketsize congressional directories will also be available at the registration desk on Leadership Day). For those chapters scheduling their own meetings, please fill out and fax to Shuan Tomlinson at 202-835-0042 the form entitled “Appointments Arranged Form,” which is available on the Leadership Day webpage. Having this information in advance will give the governmental affairs staff the information they need to tailor their advice to you for your individual meetings.  The deadline for chapters to elect the scheduling services of ACP National has passed. Those chapters that requested the scheduling services of ACP National will receive their schedules via the Leadership Day scheduling “app” for mobile devices so schedules can be accessed electronically.  Instructions for using the app will be made available soon.  A hardcopy of the schedules for which ACP National is responsible will also be provided on site at the event for those chapters that elected this service. Any chapter member who has registered for Leadership Day should coordinate with their chapter Governor for scheduling purposes.

For other information or questions about Leadership Day, please contact Shuan Tomlinson, Senior Analyst, State Health Policy & Grassroots at 1-800-338-2746, Ext. 4547 or by email at stomlinson@acponline.org.

Chapter participation in Leadership Day and the Advocates for Internal Medicine Network (AIMn) program are the bedrocks of ACP’s advocacy program.  Thank you for your chapter's support and we look forward to seeing you at Leadership Day!