From Pilot to Statewide: An Advocacy Plan for Community Health Worker Coverage, With Named Targets, Matched Channels, and a Funded Budget
Student Name
Doctor of Nursing Practice Program, Aspen University
DNP870: Health Policy, Advocacy, and Partnerships
Instructor Name
Month Day, Year
From Pilot to Statewide: An Advocacy Plan for Community Health Worker Coverage, With Named Targets, Matched Channels, and a Funded Budget
An advocacy plan turns a policy goal into a campaign: who must be persuaded, through which channels, with what resources, and on what timeline. This paper presents an advocacy plan for a composite state coalition seeking to expand a two-year community health worker pilot in Medicaid into statewide coverage in the legislative session after the pilot's evaluation. It names the targets, matches channels to each, sets out a budget with sources, and defines how progress will be measured.
The Goal and the Evidence
The goal is legislation making community health worker services a permanent, statewide Medicaid benefit, with certification standards and payment rates that support a fairly paid workforce. The case rests on published evidence, including an analysis in which an established community health worker model returned an estimated $2.47 on each Medicaid dollar spent (Kangovi et al., 2020), and on the state pilot's own evaluation, due to the legislature in September. Rodriguez (2022) argues that expanding this workforce requires sustainable financing rather than short-term grants, which is precisely what statewide coverage would provide.
Targets
The plan names eleven targets, grouped by role. Decision-makers: the chairs of the House Health and Human Services Committee, the House Appropriations Committee, the Senate Health Committee, and the Senate Finance Committee; the governor; and the governor's budget director, whose recommendation shapes appropriations. Implementers: the Medicaid director, whose testimony on feasibility carries weight. Swing votes: four legislators from rural districts in the pilot regions who voted against the pilot on cost grounds but whose constituents have used the program. The targets were chosen by asking who decides, who advises those who decide, and whose minds can change.
Channels Matched to Targets
Channels are matched to what each target reads, hears, and trusts. Brownson et al. (2018) note that policymakers are reached more effectively through channels such as issue briefs, one-on-one meetings, workshops, news media, and social media than through journal articles, and that effective dissemination considers the message, source, audience, and channel together. For committee chairs, the channel is a two-page issue brief summarizing the pilot evaluation, delivered in a meeting with the coalition's lobbyist and a nurse from the chair's district. For the governor and budget director, it is a fiscal brief showing costs and projected savings, delivered through the Medicaid director and the hospital association, which has budget office relationships. For the Medicaid director, it is a working meeting on implementation lessons from the pilot. For the four swing legislators, it is district visits by constituents who used or worked in the program, an opinion piece in the local paper written jointly by a district nurse and a worker from the pilot, and an invitation to visit a pilot site. Each target hears the argument from the person it is most likely to believe, in the form it is most likely to read.
Coalition and Roles
The coalition includes the state nurses association, which provides its registered lobbyist and member mobilization; the community health worker association, which provides workers and patients as messengers; the association of health centers, which provides data from pilot sites; and two hospital systems, which provide credibility with the budget office and rural legislators. Each member names one person to a steering group that meets every other week while the legislature is in session. The nurses association's lobbyist coordinates legislative contacts to avoid mixed messages.
Budget and Funding
The plan requires about $86,000 over nine months. Lobbying costs, including a share of the lobbyist's time and lobby day expenses, estimated at $48,000, will be paid by member associations from their unrestricted funds, since many charitable grants cannot be used for lobbying. Education and coalition costs, including the issue briefs, a public report on the pilot, site visits, communications support, and training for nurse and community health worker messengers, estimated at $38,000, will be sought from two health foundations whose grants permit nonpartisan education and research. Keeping lobbying and education funds separate protects the organizations' tax status and the foundations' rules. In-kind contributions, such as meeting space and staff time, will be tracked but not budgeted.
Timeline
September: the pilot evaluation is released, and the coalition publishes its summary brief. October to December: meetings with the governor's budget office and Medicaid director before the governor's budget is finalized, and district visits with swing legislators. January: bill introduction with bipartisan sponsors. February to April: committee hearings with testimony, lobby day, op-eds, and targeted constituent contacts before each vote. May: budget negotiations.
Risks and Contingencies
Three developments would threaten the campaign; the coalition has prepared a response to each. If the pilot evaluation shows smaller savings than hoped, the coalition will shift its message from return on investment to health outcomes and patient experience, and propose a phased expansion to additional regions rather than an immediate statewide benefit. If the state faces a budget shortfall, the coalition will ask for a smaller appropriation that preserves the three pilot regions and adds two, keeping the workforce intact while the economy recovers. If a key chair leaves or changes committees, the lobbyist will prioritize early meetings with the successor, using the relationships of coalition members from that legislator's district. Naming these contingencies in advance keeps the coalition from abandoning the effort when the first setback arrives, which is the most common way advocacy campaigns end.
Measures of Progress
Progress will be measured at three levels. Activity measures include meetings held with each target, briefs delivered, and constituent contacts. Intermediate measures include cosponsors recruited, the governor's budget including funds for statewide coverage, and each swing legislator's public position. The outcome measure is enactment with funding. The steering group will review measures monthly and redirect effort toward targets whose positions have not moved.
Conclusion
Moving from a pilot to statewide coverage depends on persuading a small number of named decision-makers and swing legislators through channels they trust, funded in ways that respect the rules on lobbying, and timed to the budget and legislative calendars. This plan names those targets, matches each to a channel and messenger, funds the work, and measures progress, giving the coalition a concrete path from evidence to law.
References
Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: New approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102-111. https://doi.org/10.1097/PHH.0000000000000673
Kangovi, S., Mitra, N., Grande, D., Long, J. A., & Asch, D. A. (2020). Evidence-based community health worker program addresses unmet social needs and generates positive return on investment. Health Affairs, 39(2), 207-213. https://doi.org/10.1377/hlthaff.2019.00981
Rodriguez, N. M. (2022). Community health workers in the United States: Time to expand a critical workforce. American Journal of Public Health, 112(5), 697-699. https://doi.org/10.2105/AJPH.2022.306775
How this DNP 870 Module 8 example is structured
DNP870 Module 8 typically closes with an advocacy plan naming targets, channels and funding. Aspen does not publish module deliverables, so check your classroom for the exact prompt. This example states the goal and evidence, names targets with reasons, matches channels to each, sets out the coalition, budget with allowable funding sources, timeline and measures.
DNP870 Module 8 questions, answered
What does DNP870 Module 8 usually ask for?
The final module typically asks for an advocacy plan that names specific targets, the channels used to reach them and how the work will be funded. Aspen does not publish module deliverables, so your classroom's instructions govern.
How do you choose advocacy targets?
Identify who decides, who advises the decision-makers and whose positions can change, then name specific people or roles rather than general groups such as the legislature.
Can foundation grants pay for lobbying?
Many charitable grants cannot be used for lobbying, so advocacy plans often fund lobbying from members' unrestricted funds and use grants for nonpartisan education, research and coalition building, keeping the two separate.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.