Perseverance and Public Policy:
Cultivating Caring Coalitions

Charlie Coffey
Executive Vice President
Government & Community Affairs
RBC Financial Group
Hospice Association of Ontario's Annual Conference
Vision, Voice, Action - Engaging the Future
Alliston, Ontario

Friday, September 12, 2003

Bill, thank you for the marvelous introduction.

I read the Chair's 2003 Report to the Membership and couldn't help but note the many achievements of the Hospice Association of Ontario under your leadership (or as Bill put it, "laying the foundation for the future"). It's clear that Bill regards his soon-to-be- relinquished role as "the opportunity of a lifetime." It's also clear that you've helped at least one other individual find her life's work…and of course I'm speaking of Janet Napper.

There's no better way to introduce the topic, Perseverance and Public Policy - Cultivating Caring Coalitions then to tell you a story about Janet. And since Janet has no idea where I'm going with this, I'll get right to it before she turns a deeper shade of red. As some of you may know, Janet invited me to speak at this conference a few months ago. She did something that distinguishes your HAO executive director in more ways than one. Along with her invitation, she thanked me for meeting with her and Trent Gow about building the Hospice Association of Ontario's public policy initiative. Her e-mail went like this: "As a result of your advice to establish a business case, we've now developed a document - Towards an Ontario-Wide Strategy for Quality End-of-Life Care that contains a 10-point priority list. We presented this information to the Hon. Dan Newman and suggested that the next step be a government-sponsored symposium to further develop a province-wide approach to end-of-life care."

I thought to myself - wow! She gets it! And that's not the end of the story…

A few weeks later, Janet invited me to introduce June Callwood at the awards luncheon (which I'm delighted to do despite the fact that June is unable to join us today). She also planted the seed about the stakeholder consultation in October, provided some detail and encouraged my participation.

Again, I thought to myself - wow! She really gets it! You're right, there's still more to the story...

Just a few weeks ago, Janet touched base again - she referred to the conference and also sent a copy of the HAO's provincial election strategy, knowing full well that Ontario would likely be in the midst of a campaign during this event and so we are!

If you're counting, I'm now up to 3 wows - Janet pushed all the right buttons to get my attention and interest - I call it creative perseverance in action. Equally important, Janet was doing what she obviously does exceedingly well - cultivating caring coalitions. Can you imagine how many other success stories are out there - right in this room? Working and building relationships with partners pays huge dividends to you and your hospices/associations. When it comes to advocacy leadership, Janet is a teacher not a student - she knows how to employ effective steps - engage people - to build a stronger hospice palliative support platform.

At the risk of repeating myself, all I can say is wow! And Janet, I had to tell this story because sharing best practices is important to the success of this conference and to making a compelling business case for hospice palliative support. By the way, your creative perseverance might have something to do with your roots and early years in the great city of Winnipeg. I'll be sure to mention your name and the impressive work of the HAO during my visit there next week.

Before I begin my more formal remarks, I want you to know that I paid special attention to news and activities revolving around Palliative Care Week this year; this was an opportunity to get up to speed on the issues relating to quality end-of-life care for Canadians before the conference. I also checked out the Canadian Hospice Palliative Care Association (CHPCA) and HAO web sites. And speaking of web sites, Senator Sharon Carstairs' site is an excellent source of information/updates. I learned much more about the Senate's significant role on palliative and end-of-life care within the federal government, especially since Sharon Carstairs' appointment as Minister with Special Responsibility for Palliative Care in 2001. After absorbing much material, I have a greater appreciation for the perseverance and work of hospice palliative care champions - for all of you.

We're about to focus on some strategies and action plans - proven advocacy steps - that will help HAO members cultivate more caring coalitions with governments and corporate/business Canada. Then we'll open up this session to a Q/A, as I really want to hear from you. Let's get started…

Public policy advocacy is about getting information to the right people at the right time and in the right way - marketing and managing what you have to say to influence your targets…and ultimately getting results. And when you get it right, you're paving the way for strong coalitions or partnerships that have immense power to push the envelope on public policy.

1. Know the plan.
Develop innovative strategies. What are your objectives in connecting with a public/private sector contact? What are your project goals/activities? What are the principles and priorities for funding - for your budget? What is your communications plan - your work plan? What are your expected results and outcomes? What about regional and national collaboration? Do you have a project evaluation plan and letters of support? If you had 5 minutes to make your case or sell a particular message, what sound bites would you use? Questions, questions and more questions…

I couldn't help but be impressed with the convincing 10-Point Priority List that the HAO team developed as part of the provincial strategy for quality end-of-life. The provincial election campaign strategy is another smart move. These activities are all part of building a business case template - a template that changes with internal/external issues, new governments, various business interests etc. The HAO continues to demonstrate it's on the right track. Know the plan.

2. Know your audience.
This is the first rule of communications...members of your team should have knowledge about key targets and players - key elected officials/business leaders-for example, what do they care about? What are their hot buttons? What committees/boards are they on? What do their constituents care about? This often means upfront and ongoing research, a robust database or someone to manage the information. It's crucial to know what motivates an elected official or business leader, otherwise you can't engage in relevant communication with them. You also need to recognize that elected officials are a unique audience. When you're crafting messages or positions on government issues, remember to use the language of government. Talk to their policies, their interests.

And of course more questions…do you know your elected provincial and federal MPPs and MPs representatives? Do they know you? For example, in the Alliston area, there's the The Honourable Jim Wilson, MPP Simcoe-Grey, and Paul Bonwick, MP for Simcoe-Grey. What do they know about HAO and this conference? Should you know your government/elected officials - should you be in contact with them? I suggest you should.
Do you know the key federal and provincial government players that developed a national strategy for end-of-life care? What about the key players in the Secretariat on Palliative and End-of-Life Care at Health Canada or the Interdepartmental Working Group that was created to implement end-of-life care initiatives across several federal departments? Should you know? I suggest you should. Know your audience.

3. Know the Issues:
What's on the radar screen of the public…the media…an MPs/MPPs constituency? Stay on top of trends so you're ready to communicate your position at a moment's notice. Keep your eyes open and your ears tuned in. Sometimes, legislation in an unrelated area can have an effect or necessitate a position in yours. Make the links, as you've done with the Romanow Report and other cases. You should also be able to assess whether an action in an unrelated arena might become an issue for you. And remember the lessons you've learned.

For example, are you familiar with the national public opinion survey released in June, where a "strong majority of Canadians who are covered by employee health benefit plans say that a range of home care services should be provided by government health plans - not by private benefit plans. 80% say that nursing care in the home, for the elderly and for people who are dying, should be paid for by government health plans." How does this issue affect HAO, your work and your advocacy?

The Joint Institute of Cancer Research and Health Canada Working Group recently held a conference for researchers and health care providers in final-stage medical diseases as well as their counterparts in the palliative care of cancer patients. How does this collaborative event affect HAO, your work and your advocacy?

"This year's First Ministers' Accord on Health Care Renewal provides $16 billion to target primary health care, including end-of-life home care; the Health Accord also initiates talks between the federal Minister of Health and provincial and territorial counterparts to address end-of-life home care." How does this development affect HAO, your work and your advocacy? Know the issues.

4. Know how the issues and the audience are connected.
You must be able to assess the impact a single action might have on different groups. Be aware that cultivating caring coalitions is political: everything is connected. Consider the consequences of your communications. Remember, there's a fine line between perseverance and irritation.

For example, in May the CIHR Institute of Aging, announced $400,000 for the research protocol to develop the Canadian Longitudinal Study on Aging (CLSA). The study will provide knowledge about the aging process that will be used to develop enhanced treatments and prevention methods for illnesses linked to aging. What's the connection here for HAO?

The Canadian Nurses' Association developed a certification program in Hospice Palliative Care. Since national standards will advance excellence in quality end-of-life care, how does this development affect HAO, your work and your advocacy?

One more example…in June Bill C-28 was given Royal Assent. "While implementing the budget commitments, this bill makes the new compassionate care leave provision…a reality," said Senator Carstairs. This legislation helps to protect jobs and income for families that need to care for a dying loved one, starting January 2004. How will this new reality impact HAO's public policy advocacy? The key to employing public advocacy steps that will help make a stronger case for hospice palliative care support is building and managing key relationships with influencers and constituencies, as well as educating various stakeholders (including elected and non-elected officials) on major aspects of your organization/hospice.

The challenge in education - understanding the dynamics - almost always has to do with timing. Messages tend to resonate when something significant happens in the public domain - something that directly interests/affects governments and their constituents (elections, budgets etc.). Given the increasing influence and activity of grassroots leadership (from backbenchers to special interest groups and everyday citizens) in terms of shaping public policy, it's very important for this growth group to also be well informed/consulted about issues.

A fundamental principle of good relationship building is to establish a foundation of Trust, Integrity and Credibility, as TIC is a must when higher levels of engagement on more serious issues, is required. When possible, framing your agenda from the perspective of the government's agenda (and its need to satisfy multiple stakeholders) is helpful for building trust and leveraging.

Does business have something to bring to the table on quality end-of-life care? I believe it does. In the broadest sense, business interests are not special interests - they are the national interest. At a policy level, business interests are about jobs, investment, growth, trade, prosperity and the standard of living. We're interested in almost all of the policies that affect the economic well being of our customers, shareholders and employees. It's essential for HAO to continue seeking out internal collaborative opportunities along with public sector/community and business partners.

I can only echo the words of Sharon Carstairs: "It's important to recognize that the key to the success of the Canadian strategy will be collaboration among governments, health professionals, voluntary organizations and communities. This is a message that I will be taking to business community members and other community leaders across the country to increase public awareness of palliative care…it has implications that extend far beyond the health sector. End-of-life issues directly affect the lives of not only patients and their immediate families; they also have a direct bearing on their employers, friends and communities." We hear you Senator Carstairs!

Cultivating caring coalitions starts right in his room. Incremental progress would not be possible without the tireless work of volunteers in the HAO and throughout the province. I see some familiar faces as I glance around the room: from Brian Freedman, Dan Dempster (both of the Dorothy Ley Hospice), Deborah Randall-Wood (Casey House), Carolyn Harding (Hospice Caledon) and Mary Gaffney (Family Services Perth Huron Hospice Services), to Mary MacDonald (Hospice Durham), Kristen Porritt (Hospice of Waterloo Region) Marilyn Mirabelli (Hospice Association of Ontario) and each and every one of you at this conference, you're all champions in my mind. I applaud your unwavering support of hospice palliative care - you bring new meaning to vision, voice, action and engaging the future - new meaning to perseverance and public policy…and new meaning to cultivating caring coalitions.

RBC Financial Group continues to support hospices across Canada, mainly through the RBC Foundation. My colleagues in Toronto have fond memories of helping Trinity Home Hospice reach new heights last October when we hosted a wine tasting and auction that raised $18,000. We're also proud of the volunteer work employees do in supporting hospices across the country.

Our own Vaughan Wilcox has been nominated for the 2003 June Callwood Circle of Outstanding Volunteers award. Vaughan has been a volunteer leader with CommunityCARE Home Hospice for more than 10 years…he mentors new volunteers and guides them through the challenges of volunteering, speaks at hospice training sessions, works with families to support loved ones in need and supports clients/families during the most difficult hours. Last year, Vaughan applied for and received a donation through the RBC Employee Volunteer Grant Program in support of his efforts with the CommunityCARE Home Hospice Program. We couldn't be more proud of Vaughan and other RBCers who lead the caring way across the country.

In closing, enlightened public advocacy leads to enlightened public policy. The Hospice Association of Ontario - and its members - has the vision and voice to make a difference. Knowing you plan, knowing your audience, knowing your issues and knowing the connections is key to your ongoing success. Try new approaches for aligning interests and support - in cultivating caring coalitions with governments, communities and businesses. And while you're at it, a little creative perseverance never hurts…just ask Janet - she gets it!

Thank you…now let's hear from you.