ADCES is actively involved in legislative activities to benefit us as clinicians and the patients and families we serve who live with diabetes. The Association advances federal legislation, responds to federal regulations, works to improve reimbursement and payment, supports state-level initiatives, and grows our advocacy network through partnerships with other organizations dedicated to those who live with diabetes. Although we are fortunate to have staff leading this work for the Association, much of the outreach to the hundreds of members of Congress and thousands in our state legislatures depends on us being active members. Our potential to realize positive outcomes from diabetes advocacy is powered by our numbers; we are a large organization whose members know diabetes issues firsthand.1
In contrast, many of our legislators do not know a lot about diabetes, relying on people like us to tell them how different bills and acts will benefit or harm the lives of people who live with or are at risk of developing diabetes.
Anytime you learn something new, all the information can feel overwhelming. Like people newly diagnosed with diabetes, who are often anxious about learning diabetes self-management, we, too, can be nervous as we reach outside of our comfort zone. Most of us are very comfortable advocating for patients and their families within our health care systems, but we may not feel confident or knowledgeable enough to take on a “bigger” advocacy role. Although we are experts in diabetes care and management, knowing all the jargon, medicines, technology, and so on, we usually do not land in this field as experts in legislative action.
To do this, we have to learn and be trained. The ADCES Advocacy Committee understands this and holds an annual training called the Public Policy Forum (PPF), which is typically held in the spring of each year. The event is free and open to all ADCES members. For those who are unfamiliar, this half day of training includes presentations by experts outlining current events on the Hill, panel discussion from members who are active advocates, and in-depth presentations on the ADCES legislative priorities. This past June, attendees learned about and received training on how to discuss key legislation, including the Expanding Access to Diabetes Self-Management Training Act (DSMT Act), Medicare payment rates, and the new Diabetes Interventions Addressing Barriers to Enrollment, Technology, and Education Services (DIABETES) Act.
The PPF Hill Day is scheduled for the following day. All that we learned is fresh in our minds, making it easy to step into our advocacy role! To help us feel fully prepared, the PPF ends with breakout sessions (by Hill Day team) with a grassroots coordinator, ADCES Advocacy Committee member, or other seasoned advocate serving as a facilitator to discuss meeting plans for Hill Day. Typically, each team has at least 2 to 3 PPF-trained diabetes care and education specialists. Not all PPF attendees participate in Hill Day, but we see more and more participation each year.
During team breakout sessions, roles and responsibilities for the meetings are set. Some groups may agree that each person will discuss one of the bills, and other groups may have one person discuss the bills and have others add personal stories on how these bills will affect diabetes care and education. Personal stories have the most impact because they give a voice to why these bills are so important.
Virtual meetings with Congressional offices are set in all states that PPF attendees are from.
Meetings take place throughout the day and typically last 15 to 30 minutes. Most meetings are held with a staffer assigned to health issues for the senator or representative. After the first meeting on Hill Day, the group easily falls into their roles and scripts for great meetings with legislators. By the end of the day, after 4 to 8 virtual Hill meetings, you may feel exhilarated, exhausted, proud, or all of the above.
Like print education materials that we provide to patients and families to support what they learn, ADCES provides many resources to support this advocacy effort, including an outline for preparing, executing, and following up on the meetings with legislators and a suggested helpful topic outline for the meetings. We are also provided with detailed Leave Behind handouts on each legislative act or bill for us to review more carefully (named for when advocates would “leave behind” these handouts with offices after inperson meetings). Take a look at the 2025 agenda and leave behind materials.
Advocacy is a natural response to address the gaps in diabetes care. As you participate in the ADCES Public Policy Forum, you will become better equipped to advocate. We hope you will join the others who have been thrilled to add this to their skill set, increasing the number of ADCES members involved and making an impact by meeting with your state legislators on Hill Day next year. Being a part of ADCES Advocacy will help you see the greater influence that you have as diabetes care and education specialists, locally and nationally, on important legislative decisions.
Be ready: Read over your prep materials before the training. Know what you know and what you don’t know. Ask questions for clarification.
Work together: Make a plan so you know what you will be doing and saying. Consider role-playing with your team during your planning time. If this is your first Hill Day, rely on your group members to guide and support you.
Know your environment: Be professional and respectful. This includes everything from dressing nicely and showing up on time to keeping the conversation polite despite political differences. Also, know who you are talking to and meet them at their level regarding the issue—it’s okay to oversimplify.
Speak from the heart: Your experience matters, and knowing your personal story will have more of an impact than a generic one. Consider your why and build that into your ask.
Ask with confidence: Make a clear request for what you would like to see happen after the meeting. Use specific language related to the issue and be ready to explain further to prove your point.
Visit the Diabetes Advocacy and Policy page on the ADCES website. There, you will find lots of information about current legislative priorities, upcoming events, and ways to get involved. Visit the ADCES Legislative Action Center to send letters to your senators and your representative. Take a minute to add in a personal story to these predrafted messages, or if short on time, just click send. These emails and the number of emails are noted in our congressional offices, so it does make a difference.
All authors contributed to the conception and design, drafting, and revision of the article and approved the final version for publication.
The authors declare having no professional or financial association or interest in an entity, product, or service related to the content or development of this article.
The authors declare having received no specific grant from a funding agency in the public, commercial, or not-for-profit sectors related to the content or development of this article.
Hannah Martin https://orcid.org/0000-0002-8382-5301
References
Howe CJ, Martin C. Step up your advocacy role. J Pediatr Nurs. 2021;57:111-112. doi:10.1016/j.pedn.2020.12.007
Martin T, Martin H. Advancing diabetes care through advocacy: insights from ADCES’s First State Policy Forum. ADCES in Practice. 2024;13(1):42-45. doi:10.1177/2633559X241301517
