Advocacy for seniors and the providers who serve them is a core task for LeadingAge and for its state partners across the country, but direct advocacy by LeadingAge members carries extra weight with elected officials and regulators. And that advocacy need not be limited to face-to-face meetings with officials. Direct communication with the public is important to help move public opinion and to raise the profile of our field as an advocate for the needs of the elders we serve.

A good recent example of public advocacy is “Seniors Are Being Ill-Served in Pennsylvania,” an opinion column published in the Pittsburgh Post-Gazette. Written by Paul Winkler, president and CEO of Presbyterian SeniorCare, Oakmont, PA, the column argues that federal and state funding rules unnecessarily restrict the options for many seniors:

Today, a variety of service options exist to address individual needs by means other than what used to be called nursing homes. People can seamlessly transition back and forth from assisted living to home care, to senior housing, to adult day-care services and in and out of skilled-nursing facilities based on their specific needs at any given time.

But while models of care and technology have evolved with more focus on keeping seniors independent longer, federal and state funding for people with limited income has not kept pace. Many seniors are forced prematurely into skilled-nursing facilities because that is the only way they can receive funding assistance.

LeadingAge interviewed Winkler and Ron Barth, president/CEO of LeadingAge Pennsylvania, about how such public advocacy advances the work of our field and why more members should work to publish their own views in local media.


LeadingAge: How did the decision to write this op-ed come about?

Paul Winkler: This has been done very much hand-in-hand with LeadingAge Pennsylvania. We’ve had a long history of collaboration, and we had done a couple of op-ed pieces in the past, where Ron and his team helped a great deal in putting together a message. We even did an editorial board [visit] together with the Post-Gazette.

Ron Barth: We have our own media consultants and we have a vision of senior services that we try to publicize throughout the state. We want to have articles and news stories that will be read by policymakers, in addition to doing our own advocacy in the state capital. This is also done to reach out to other providers to let them know what the leaders in the profession are doing. We always know it’s more effective and easier to place an op-ed if we can get a provider from that area—in this case, Pittsburgh—and of course Presbyterian SeniorCare was a natural choice.

Paul Winkler: This one was an outgrowth of a joint hearing of both the Pennsylvania House and Senate committees on aging, who met in Pittsburgh as one of [a series of] hearings around the state. Ron reached out to us about testifying at the hearing so we prepared for that, and then they [members of the Senate and House aging committees] came here the day before and did a site visit.

Following that, the thought was, “Why not do something with this?” It was playing off the momentum of the spotlight on this testimony and how we need to be long-term, forward-thinking and proactive, making a change from the year-to-year mentality that is pervasive. And that’s where the collaboration for the op-ed came in. The timing of this [was such that] this ran in the Post-Gazette right after the gubernatorial election.


LeadingAge: What efforts have you made to leverage this?

Ron Barth: We put things in our newsletters and we do work with other members throughout the state to place op-eds. It’s one thing for me, as a paid person in Harrisburg, to talk about something, and I may get quoted in the Harrisburg paper, but it’s more effective if we can get the local papers to see how this is affecting people in their particular areas. It’s the same way we approach advocacy with legislators. It’s one thing for us to go down to the Capitol and talk about an issue; it’s another thing for their constituents to come to them, or for them to visit our member communities, and learn firsthand about issues from their constituents.

Paul Winkler: LeadingAge Pennsylvania has had a vision document, NorthStar, which has been through a couple of iterations … a great piece members can use for strategic planning with their boards. It’s a great document in terms of guiding principles for the long-term care future. It helps in framing these things and I always go back to it. It’s a really valuable strategic planning tool, and usable by members anywhere across the country; our issues are not unique.

Ron Barth: One of the things we’ve really emphasized in Pennsylvania is that we’re an “association of solutions.” The status quo will not be successful in the future, and our members have really been leading in providing 21st-century ways of giving services to older adults. It’s not a siloed approach; it’s about providing services where and when people need it.

Paul Winkler: I had the good fortune of serving on the LeadingAge Pennsylvania board, and we really focus on advocacy and how everyone can advocate in some way. And as leaders of provider organizations, historically we didn’t see our role as advocates, but in the environment we’re in now we are, and in the future will continue to be.

If we’re not doing something to advocate for our field policy-wise, then we’re ignoring something in our core job descriptions. Government relations are so important. Whether [that means] inviting legislators out or other activities, these are relatively painless ways to do something that can be significant in getting our message out and raising visibility for our organizations. Because we have such great staff at our state associations, they are happy to collaborate in writing something, and we can put it out there to raise visibility for the issue and the member. It’s a win-win.


LeadingAge: Have you had op-eds published before?

Paul Winkler: Yes, a couple of times. One article that was pretty powerful was one that two of us LeadingAge Pennsylvania members published on a “perfect storm” of funding vs. demographics, and the LeadingAge Pennsylvania staff helped with that. There was also a video roundtable at the Pittsburgh Business Times that included three providers.

Ron Barth: One thing this does is build on itself. Paul has established himself as a leader, and when there are questions or interviews needed on senior services, [media] know to contact Paul because his name’s been out there. That’s what we want to do around the state; we want our members to become contacts for the media. I’ll occasionally put out op-eds or at least letters to the editor, but as much as we can, we want to highlight members and it builds on itself after a while.


LeadingAge: What impact do these articles have on politicians and regulators?

Paul Winkler: We sent copies of the op-ed to all the legislators that are in our area. That was easy to do and an opportunity to follow up, and we have heard back from several.

LeadingAge: Regarding the situation discussed in the op-ed, the way Medicaid funds for aging services are allocated, what is your prognosis?

Paul Winkler: Pennsylvania was not a leader in rebalancing by any means, so we’re still lagging in that area and that’s one of the key points made in the article. We don’t have Medicaid waiver dollars to support people in assisted living or personal care. We’re still in that painful period. The state wants to rebalance and decrease dependency on nursing homes … but there hasn’t been enough building of that infrastructure for support alternatives, so maybe it’s a bigger issue in Pennsylvania than in other states that are further along that journey.

Ron Barth: There’s probably not a state out there [that is] not facing a funding crisis for social services, and services for older adults are one of the major expenses. We have an aging society, in Pennsylvania in particular, and in Pittsburgh even more so. These are among the oldest demographic regions in the country.

Honestly, the way we approached advocacy in the past was to say “You just have to give us more money, we’re not getting enough.” But we’re changing that to say that we need to change the way we’re providing services. We’re looking for solutions and saying, “We’re part of the solution as well.”

Something has got to change. Whether that’s optimism or just facing reality, something’s got to change. So instead of trying to react to whatever they’re doing we’re trying to say “We’ve got some solutions now.” We think they’re going to work so let’s talk about those before this whole system frankly just collapses and something will have to take its place. I tell worried members and others that we’ll be able to survive, and the state will have to find a way to help its people survive because these services are absolutely needed. Rather than waiting for events to overtake us, let’s try to find a way to mold the events to how we’d like to have the future look. Let’s design our own future here.


LeadingAge: What have you learned about the style of writing that’s effective in these kinds of articles?

Paul Winkler: We know that what Larry Minnix does effectively is tell stories; I don’t do that as well as I should. We need to look at how we weave the human face into these issues better. In testimony it’s a little harder to do that, but having a story to tell is really important. We all have those good stories in our organizations, and we should do more to use them.

From the provider side, we have not historically thought about doing this kind of thing and it can be daunting. Do you really want to put yourself out there in that way? You can talk yourself out of it. There’s worry about saying something that will be inflammatory or offend someone or whatever. That’s where the collaboration with the state association is so great; it gives you confidence and makes it much easier than if you had to do it yourself. There’s a way to do these things that can be relatively painless and really effective too.