Moving Legislation

Patrick Coyne has a clear focus: improving palliative care in Virginia by giving health care professionals first-hand exposure to advanced techniques in pain management. As Coyne says, “education forms a practice foundation, but clinical experience drives practice.” But securing government funding for a clinical palliative training program was proving difficult; previous legislation had either died in committee or had funding provisions stripped away.

During the 2004 Mayday Pain & Society Workshop, Coyne was exposed to new tips for interacting with policymakers and their staff and intense practice delivering his message under the tight time constraints of a five-minute meeting. He learned the importance of having a specific ask for each meeting and a concise leave-behind document to facilitate follow-up.

Meeting with experts in both federal and state legislation, Coyne quickly saw that national legislation wasn’t the ticket. Coyne’s Burness coach arranged for a follow-up meeting with Senate staff to guide his advocacy plan. The staff’s advice was that an appropriations earmark rather than passing freestanding legislation would be an easier path.

Armed with a new policy strategy and new tools, Coyne redoubled his efforts. By more effectively leveraging the lobbying capabilities of coalition partners in the pain and chronic disease worlds, he began to make real headway.

Even in his policy endeavor, media training proved crucial. Coyne knew he was lacking a critical ingredient: the public face that would make improved pain treatment more real. He connected with Gloria Oates, the widow of baseball great Johnny Oates, who speaks publicly about her late husband’s devastating cancer pain.

Coyne, along with his coalition partners, especially the American Cancer Society, orchestrated an all-out campaign, arranging media interviews for the Oates family, meetings with legislators, organizing coalition partners to go door-to-door in the state legislature, and orchestrating thousands of grassroots supporters to make phone calls and write letters to elected officials.

The pressure paid off. Even with Virginia in a budget neutral year (no increased spending), Coyne and his allies secured a $150,000 line-item appropriation for the pain training program. They are now tracking the effects on practitioner attitudes with follow-up surveys.

And the training program is still gathering support. The budget submitted by the Governor of Virginia included a $150,000 funding request for the clinical palliative training program, meaning any legislative effort is to increase, rather than preserve, the program. In the Virginia House, the funding request is for an additional $100,000, and in the Virginia Senate the increase is $600,000 (though still pending). Now Coyne and company can launch in action again.

Patrick Coyne, RN, a 2004/05 Mayday Fellow, is Clinical Nurse Specialist and Clinical Director of the Thomas Palliative Care Unit at the Medical College of Virginia Hospitals/Virginia Commonwealth Health Systems.

23 March 2016