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Understanding and Influencing the Legislative Process

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The Society of Gastroenterology Nurses and Associates, Inc., presents this monograph as an educational treatise for use in developing personal or organizational understanding and action regarding the legislative process. The Society of Gastroenterology Nurses and Associates, Inc., assumes no responsibility for the practices or recommendations of any member or other practitioner, or for the policies and practices of any organization.


This monograph will familiarize the gastroenterology nurse and associate with the basic tools for understanding the legislative process. The information provided will enable the individual to gain entrance to the legislative process at all three levels of government: local, state and national.


The importance of political involvement by nurses cannot be over-emphasized. Bills for funding nursing education and nursing research come before Congress each year. Communication can have an important impact on legislation. Nursing practice is legislated on all levels and deserves our attention and input. Know your legislators, contact them regularly, and educate them on nursing and health care issues.

SGNA Legislative Platform

The Society of Gastroenterology Nurses and Associates may support responsible, appropriate legislation to:

Provide funding for nursing education, including undergraduate, graduate and research. 
Increase utilization of nurses in expanded roles such as nurse practitioners, midwives and clinical specialists. 
Expand consumer freedom of choice in selection of primary or secondary health care providers. 
Provide direct reimbursement to nurses in expanded roles. 
Increase funding for digestive disease research and patient education. 
Increase nurse representation on all local, state and national health policy-making bodies. 
Support legislative efforts to improve the safety of the health care environment for health care providers, patients and volunteers. 

Communication with Your Legislator

Telephone Calls

A telephone call to your legislator is a quick and easy way to register an opinion on an issue, especially if the receiver is doing a count of responses on a bill. If more details are needed concerning an opinion or issue, a letter is more effective.

 Prior to your call, take time to get the facts together, i.e., who you are calling, the problem or bill number, and one or two reasons that support your opinion. Be brief! 
 When calling, ask for the Health Legislative Assistant (LA) - not the legislator. The LA will take your concerns and communicate them directly to your legislator. 
 State your name, title and other credentials, (Do not assume the person you are talking to knows what your professional abbreviations stand for.) 
 State the reason for the call, supporting data and the action you want taken. Get a reply, reiterate the action and reply, and end your call with a thank you. 
 If you want a letter to acknowledge your call and/or to provide information requested, say so and provide your home address. 

Writing a Letter or E-mail

A personal message to your legislator is an effective way to express a concern regarding an issue that is too long for a telephone call. Letters and e-mails from individual constituents make a difference. Legislators use these messages to show support or opposition on an issue.

 Use the proper title of the person to whom you are writing (i.e., Representative, Senator or The Honorable. See page 4 for addresses.) 
 Include your full name, title and home address; telephone number is optional. 
 The opening of your letter or e-mail should include your credentials, the issue you want to address, and the bill number. Enclose a fact sheet if you are from an organization. 
 Supply data and statistics to support your position. Specify how the bill will affect the legislator's district or the effect it will have on the community. Clearly state the outcome you want from the legislator. 
 Keep your communication brief and direct. Address only one bill or issue in your letter or e-mail. 

Social Media

Social media outlets like Facebook and Twitter have emerged as the easiest and most immediate method of contacting your representative. Communicating with legislators through these social media sites has an advantage over letter and e-mail writing campaigns since it occurs in the public eye. Other constituents can read and comment on your message, encouraging dialogue and raising awareness of your issue or concern.

 Most legislators post a direct link to their Facebook and Twitter pages on their official Web site. You can also look them up through the search feature on the social media sites. 
 Your message should be brief and to the point. Most social media sites have word limits on what you can post. 
 Remember your post is available for all public to view. Be respective and never use offensive language. 


A personal visit to your legislator stresses the importance of, and your commitment to, an issue. Direct contact impresses your legislator and supports any previous telephone call and/or letter(s).

 Make an appointment in advance. Indicate the reason for the appointment. Be brief! Plan on a 15-minute meeting. 
 Confirm the appointment by telephone two days prior to the meeting. 
 If a group visit is planned, limit the group size to no more than five people. (Larger groups can be threatening.) Have a group meeting before the visit. Appoint a spokesperson who will introduce each member, state the issue, introduce the presenters, and summarize the visit. 
 Be prepared to answer questions. Know both sides of the issue. If you do not know the answer, offer to obtain the information and send it in a timely manner. 
 Solicit the legislator's views on the issue. Listen carefully. Attempt to understand their point of view. 
 Summarize your understanding of the meeting and any follow-up action to be taken. 
 Leave behind a fact sheet that summarizes your presentation. (See sample SGNA fact sheet on page 5.) It should be one, typewritten page that includes your name, title, address and phone number or leave individual business cards. 
 Send a thank-you letter restating your position. Enclose any information promised or that appropriately backs your view(s). 
 Offer to be a resource person regarding the issue discussed and for any future health care and/or nursing issues. 


Lobbying is an attempt to persuade or influence the members of a governmental body at the city, county, state or federal level. The purpose of lobbying is to enact, modify or stop the passage of proposals made by a legislative body at any level. Lobbying can take place at the individual or organizational level.

Individual Lobbying

Lobbying by the individual can occur on a local, state or national level. It is effective grass-roots action to support an issue or person.

• Register and vote! Voting gives individuals the power to express personal opinions and to influence outcomes. Voter registration records show who is currently registered and when they last voted. The opinions of registered voters carry great influence. 
• Call your legislator regarding health issues that are on the legislative calendar. Follow-up with a letter and/or personal visit. 
• Monitor the activity of your State Board of Nursing Practice Committee. Keep nurses within your organization advised of vacancies on state boards and commissions. 
• Obtain support from nursing colleagues (i.e., work place, educational institutions, community organizations). 
• Support other nursing groups and their issues, provided there is no conflict of interest. 
• Form a political action committee (PAC) to raise funds to help the election campaigns of political candidates who support your legislative objectives. 
• Run for public office and/or support activities of other nurses who are running for office. 
• Monitor elected officials' performance on health issues. 
• Obtain information about local issues that affect you as well as your professional practice. 
• Write letters to editors of local newspapers or articles concerning current legislative and/or community concerns. 
• Attend community public hearings that pertain to health issues. 
• Be active in community interest groups. 
• Endorse candidates who are empathetic to nursing issues. 
• Demonstrate that those issues you are bringing to the local government's attention are important to a number of citizens or nurses through letters of support, testimony and petitions. 
• Seek appointment to county health commissions or hospital boards. 
• Establish yourself as a legitimate resource person, obtaining personal letters from recognized community leaders to enhance your credibility. 

Organizational Lobbying

As an organization begins to lobby there should be a core of members who monitor legislation at all levels of government: local, state and national. The most important thing to keep in mind about organizational lobbying is that it must be a united effort and be highly goal-directed. Issues that directly affect the members, either their practice or their profession, should be the first priority of the organization. This can be followed by more general issues (i.e., other organizations' issues), then more national or global issues.

• Know the demographics of the state population: age, party affiliation, sex, social economic status of the voter. 
• Know the person(s) in all three levels of government (local, state, federal) who write legislation that could affect your organization. Know their party affiliation, voting record and position on health care issues.
• Telephone the legislator at the local, state and federal level who is involved in legislation that affects your organization. Identify yourself and your expertise. Be clear, brief, and state the action you want taken. At the end of the conversation, review the call and the action you want taken. 
• Write letters supporting/opposing issues. As an organization, one person can develop a form letter that can be individualized by each person and issue. 
• Visit the legislator at a mutually convenient time. Become acquainted with him/her. Make an appointment in advance specifying the issues to be discussed. Arrive with an agenda. Know what you want to achieve. Have a brief written summary ready to leave with the member upon departure. 
• Offer your legislator support on other issues as long as there is no conflict of interest. This support will be remembered. 
• Work with the congressional staffers by developing an effective on-going relationship. 

The Political Action Committee

In 1971, Congress passed legislation allowing associations to create political action committees (PACs). The core of a PAC can consist of a few members who are highly organized and can raise money in the name of their cause.

PACs are formed for the express purpose of raising funds to support the election of legislators. Associations that have or intend to form PACs must closely observe applicable federal laws and regulations. Criminal and civil sanctions can be levied for violations.

Association funds may not be used for political contributions. However, an association may support the work of the PAC by providing administrative services, for example. Legal assistance should be sought by associations or other groups contemplating the formation of a political action committee.


The power to influence the course of a bill lies with the ability to motivate people to work with you and for your cause. One way to do this is through networking with others. The government does not work in a vacuum. People and concerns drive legislation.

No bill passes solely on its merits. Facts and evidence assist legislators in their decisions. A bill's impact on legislators' districts has a great impact on their decisions to support or oppose that proposal. By marshaling other voters who support your point of view, you multiply your chances of success in the legislative arena.


A coalition is a group of organizations that share a common interest on a single issue. Coalitions can exist at the local, state and federal levels. The reason for a coalition is simple - few laws get passed through the action of just one citizen. Local nursing organizations can increase their political strength by forming coalitions with other groups. The process of building a coalition is not difficult.

• Know the political environment in which you will be lobbying. 
• Identify potential collaborators. 
• Call an informal meeting for individuals to explore an issue and to identify mutual concerns. 
• Identify a common goal. 
• Build credibility. 
• Link members of a coalition. Each member contributes and receives from the coalition equally. 

Telephone Tree

A telephone tree provides rapid mobilization of personnel and resources. It also enables the rapid dissemination of information important to the members, such as the names of elected officials and their rank and file or vice versa. It utilizes pre-existing lines of communication based upon organizational structure.


Roundtables establish a network of nurses who can help one another when the need arises. They provide the medium for nurses to get together, exchange telephone numbers and discuss similarities and differences in their positions.

Congressional Addresses/Phone Numbers

The President
The White House
1600 Pennsylvania Avenue Washington, DC 20500

Dear President ___________________

Senator _____________
United States Senate
Washington, DC 20510

Dear Senator _______________

Public Affairs Office
Library of Congress
IO 1 Independence Avenue
SE Washington, DC 20540

House Bill Status Office
696 House Office Building Annex #2
Washington, DC
(202) 225-1772

House Documents Room House Annex #2
B-18 Ford House Office Building
Washington, DC 20515-6622
The Vice President
The Executive Office Building Washington, DC 20500

Dear Vice President ______________

The Honorable _______________
United States House of Representatives
Washington, DC 20515

Dear Congressman __________________

Superintendent of Documents Government Printing Office
c/o Office of Congressional Legislative and Public Affairs
732 North Capital Street NW, Room C-804
Washington, DC 20401

Senate Bill Status Office Senate Library
The Capital #S332
Washington, DC 20510

Senate Documents Room
Hart Senate Office Building #BO4
Washington, DC 20510
(202) 224-7860


Abood, S. (January 31, 2007). "Influencing Health Care in the Legislative Arena". OJIN: The Online Journal of Issues in Nursing, 12(2), Manuscript 2.

Brownson, R. C., Chriqui, J. F. and Stamatakis, K. A. (September 2009). Understanding Evidence-Based Public Health Policy. American Journal of Public Health, 99(9), 1576-1583.

Hurdle, A. (Spring 1989). Legislative Update: Having an Impact on Your State's Legislation.
Gastroenterology Nursing.

Mason, D. J., Leavitt, J. K. and Chaffee, M. W. (Ed.). (2012). Policy & politics in nursing and health care (6th ed.). St. Louis MO: Elsevier Saunders.

Sheck, P. (Fall 1989). Legislative Update: How a Bill Becomes Law. Gastroenterology Nursing.

Walrath, N. (Fall 1989). Legislative Update: A Voice in Washington. Gastroenterology Nursing.


Prepared and written by the SGNA Legislative Committee and adopted by the SGNA Board of Directors, January 1992. Reviewed 1996. Reviewed and revised by the SGNA Healthcare Policy Committee, 2012. Published as a service to members by the Society of Gastroenterology Nurses and Associates, Inc.