In a Crisis, Keep Your Hospital Operators Close and Your Legislative Friends Closer

Pandemic Coverage

Lessons in engaging government officials during the pandemic

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Illustration by Roy Scott


Hospitals are community assets, and legislators are public servants. Both have a shared commitment to serve the health of the community, which creates a crucial synergy in a public health crisis. The pandemic of COVID-19 pulled hospital operators and local, state and federal legislators together against a common crisis, and each group brought unique strengths to the challenge. Hospital government relations professionals solidified their working relationships with legislators in ways that yielded maximum collaboration during this time of threat to the health of the communities they jointly serve.

The COVID-19 pandemic put hospitals and legislators in unprecedented, but not completely unfamiliar, territory. Hospitals prepare for these types of events through internal drills and external exercises, often facilitated by county agencies. Hospitals routinely train for events such as fire, active shooters, flu epidemics or mass casualty incidents. Legislators at all levels are constantly vigilant against threats to their constituencies, whether the threats are health-related, economic, criminal or environmental. What is different about COVID-19 is that in many cases it has been slow moving compared to more typical health emergencies. It has not been something that one reacted to with the same speed and short-term response such as in a factory explosion or a massive car pileup. This difference has given time for hospitals and legislators to learn from each other and strategize collaboratively on responses.

Hospitals' government relations staff have the responsibility to facilitate teamwork between hospitals and government officials. COVID-19 allowed the hospitals' government relations teams to put new mechanisms in place to work more closely over longer periods with their legislative colleagues.

Although many hospitals activated their hospital incident command systems, which engage collaboration between the facility and local or county emergency management agencies, legislators often are not familiar with how those long-established systems function. Since health care is just one of the many areas legislators must focus on, legislators often are not as aware of how hospitals operate in a crisis. Government relations teams needed to inform legislators how hospital incident command systems operate in conjunction with local agencies using established protocols (for example, how the Strategic National Stockpile is allocated and distributed). Conversely, legislators have a broad knowledge of community resources and leaders across their districts or states. They can identify potential partners outside of health care and facilitate coordination between those organizations and the health care providers. Also, legislators can seek input from hospitals on emergency legislation being drafted and give government relations staff early indications of additional resources the government may be able to bring to bear.

Hospitals' government relations leaders were able to implement new strategies to engage legislators when facing COVID-19. Some of the initial lessons learned for hospitals' government relations' staffs during COVID-19 were:

  • Audit your legislative contacts. Ensure that your local, county, state and federal legislators and staff contact information is up-to-date. Ideally, have initial conversations with legislators, confirm your primary point of contact and in what circumstances should communication be elevated directly to the legislator.
  • Be familiar with your hospital leadership and hospital incident command system structure. Confirm which hospital leader is in what role during the crisis. Some hospitals activated their incident command system, while others may have modified their organizational structure to manage resources given the community situation. Understanding leadership roles and who can provide you with answers to legislators' questions as the pandemic evolves is critical to your being able to triage communications from legislators.
  • Given the nature of the COVID-19 crisis, the most common area in which legislators wanted to help was securing vendors for personal protective equipment (PPE). Government officials are well connected with the business community, including manufacturers and suppliers of PPE and related products. (The majority of calls many government relations staff received were from officials who knew of potential sources of PPE). Establish an understanding in your hospitals about who should be connecting with those leads and how they can be vetted quickly.
  • Proactively reach out to your legislators and/or their key staff members individually. Educate them on hospital incident command processes and communication chains during the crisis. It is not uncommon that local legislators may reach out directly to the hospital CEO, but in a health care crisis, hospital operators need to focus on operations. The government relations staff should be managing communications with legislators. Inform your legislators and staff to direct their inquiries to you and ensure that hospital operators are aware of the process so they can redirect calls back to the government relations staff. Often the inquiries can be answered by the government relations staff and not take up operators' time.
  • Initiate conference calls exclusively for legislators. Although hospital incident command systems typically include a public information officer, legislators may desire, and hospitals may need them to have, more details about a situation than may be immediately available to the public. This can help with collaborating on strategies to acquire resources or overcoming barriers. The government relations staff can arrange invitation-only conference calls with area legislators and/or their staffs and have specific hospital operators provide briefings. By making these exclusive, noting they are not open to the public or media and do not violate "sunshine laws," hospitals can efficiently update legislators on the situation and provide a venue for them to ask questions they might not otherwise do publicly.

By implementing these strategies, government relations leaders were able to streamline their organizations' collaboration with area government officials as they jointly faced COVID-19.

Once the pandemic ends, the government relations team must get consensus from the hospital operators on lessons learned and advocate for change by partnering with legislators for either policy or process improvements so the community, through its legislators and hospitals, are prepared for the next public health crisis.

Taken as a whole, these actions can set a model for new hospital-legislator collaboration in the post-COVID 19 era. Both parties learned much more from and about each other, especially as it relates to crisis response. It is said everything will be different now, and these steps and the resulting development of more agile communication tools and processes can provide a framework for government relations staffs and legislators going forward.

Paul N. Olivier is the chief network integration officer for Bon Secours Mercy Health Great Lakes Group, and is also responsible for government relations in the company's Youngstown, Ohio, market. Paul has been handling government relations for over 18 years in Youngstown.


Copyright © 2020 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3490.

Copyright © 2020 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.