Accessing care: Organizing for change

Click here to view a general explanation of Organizing for Change

Many communities have organized at the local level to advocate for and work towards improving access to health care services. 

Community-based organizations often help residents and other stakeholders press for changes in policies and practices to expand access to care or improve the quality of that care. 

Broad-based coalitions are needed to change health policies and practices.  Coalitions include residents, advocates, faith leaders, service providers, and others working to improve conditions in the community.  Efforts might focus on one health issue or might comprise large campaigns addressing a range of community issues, including health care. 

 

Organizations in your community may already serve as vehicles for grassroots community organizing. 

Community organizing groups may address health care by tackling specific aspects of an issue.  Organizing efforts might seek to:

• sustain or increase funding for essential health services and prevent budget cuts
• keep important facilities such as clinics and hospitals open and operating at full capacity
• ensure that certain groups or populations are being served by available resources
• expand coverage by investing in outreach and enrollment efforts
• augment existing programs to cover non-eligible populations such as adults without dependent children or undocumented immigrants 

The Pacific Institute for Community Organization (PICO) is a national network of faith-based community organizations working to create innovative solutions to problems facing urban, suburban and rural communities.  Since 1972, PICO has worked to increase access to health care, improve public schools, make neighborhoods safer, build affordable housing, redevelop communities and revitalize democracy.

With more than 1,000 member institutions representing one million families in 150 cities and 17 states, PICO is one of the largest community-based efforts in the United States. 

 

Contra Costa Interfaith Sponsoring Committee (CCISCO), a PICO network member located in California, has worked on numerous health care issues affecting the county's poorest residents. 

In addition to efforts to enroll uninsured children in available health insurance programs, CCISCO members play a leadership role in securing countywide passage of a special parcel tax, the proceeds of which would keep open a local hospital serving more than 330,000 people.  CCISCO leaders and community residents mobilized to make phone calls and walk neighborhoods during the 85-day campaign.

 

Community organizing groups, led by people most affected by the problems being addressed, have unique insights into the solutions that need to be crafted.  In Emporia, Kansas, over 240 Hispanic, Anglo, and African American residents came together to press city and county officials for a better public transit system—one that would ensure better access to health care, hospitals, and jobs.  The diverse coalition was organized by Friends in Faith Serving Emporia (FFSE), one of the Center for New Community's faith-based organizing projects. 

 

Residents successfully outlined the need for new and expanded bus routes to better serve neighborhoods and trailer parks; bi-lingual dispatchers, drivers, signs, and literature to better serve Emporia's largely Hispanic south side. According to the Reverend David L. Ostendorf, Executive Director of the Center for New Community, “the changes recommended by FFSE and instituted by the L-CAT system resulted in seven straight months of record ridership—300 riders per month over what the system originally projected.”  

As a result of the changes, health care needs are better met and the immigrant community, in particular, has new access to vital community services.

 

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Before you give... Organizing is time-consuming and challenging, but one of the most empowering ways of enhancing health and wellness in disadvantaged communities.  It involves residents themselves in analyzing issues, deciding what changes need to occur and leading the effort to make change. 

Organizing strategies maximize the power and influence of people who are often voiceless and powerless in decisions affecting health policies.  Because community groups engaged in organizing have a profound and invaluable connection to their constituency, they are extremely knowledgeable about the types of policies and programs that really work.  

Groups that organize can be great resources for donors simply wishing to learn more about issues in a community or region - whether or not you choose to fund organizing directly.

Questions to consider before you give:

1. What issue(s) do you want to tackle?  Is community organizing the best strategy for addressing the issue?
2. Are there groups organizing residents on these issues? 
3. Does the group have a clear grasp of the issue, the context and possible solutions? Do they have access to any outside expertise they may need?
4. What facts and analysis do they use to support their position/approach?
5. Does the group truly have the skills to organize, market, speak or testify to policy makers?  Who will run meetings, take the minutes, manage finances, distribute literature, work with the media?
6. Does the group have the strategy and allies it needs to win?  Can it gain additional support? 
7. What is the group's timeline? Is it realistic?
8. Having considered the other questions, what is the likelihood of success for the group? Will failure on a particular cause curse the entire venture or might the leadership skills and experience gained empower the group for the next cause?
9. In addition to grant money, are there other ways you can assist the group in meeting their goals?

You may find some questions irrelevant or have a few questions of your own, not listed here.  This list is not meant to be exhaustive. 

Try using the questions as a springboard for lively and respectful conversation between you and a potential grantee.  Or, as a way of discussing a grant proprosal with your fellow trustees, your family or other board members.

Related Reading

Other Ways to Take Action in Accessing care

• 2010 Health Care Reform: SmartLink Breaks It Down

  As a donor, you may be wondering how health care reform will affect individuals and families served by nonprofit health care providers, as well its impact on nonprofit organizations themselves. SmartLink has developed an overview of the Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act. Consider this summary a starting point. Over time, we will learn much more about how donors and communities can influence the health care for low-income communities.

• A FEW WORDS WITH Atum Azzahir

• Advocating for change

• Developing new programs

• Strengthening community groups

• Tackling immediate needs