Health Policy Agenda

Definitions, Principles, Outcomes

The following framework was established by the AACN Board of Directors in January 1996 to be used as one guide in developing, implementing and evaluating the association's health policy agenda. In April 1996, the Public Policy Work Group reviewed and clarified this framework to define a future health policy agenda that is founded on defined member needs and consistent with a healthcare system driven by the needs of patients and families.


The American Association of Critical-Care Nurses is a 501(c)3, not-for-profit educational organization.



The Department of the Treasury defines "lobbying" within the Internal Revenue Code as "attempting to influence legislation by propaganda or otherwise." An organization is lobbying if it attempts to influence legislation through contacts or urging the public to contact members of a legislative body for the purpose of proposing, supporting, or opposing legislation, or if it advocates for the adoption or rejection of this legislation.

A 501(c)3 organization is not engaged in lobbying if it responds to a request of a legislative body to provide testimony on pending legislation. If the 501(c)3 organization initiates the request, however, a different rule applies.

A 501(c)3 organization may lobby but is restricted in the extent of lobbying it may do. Regulations state that no SUBSTANTIAL part of the activities of a 501(c)3 organization may consist of lobbying activities. Neither the Internal Revenue Code nor the Treasury regulations define "substantial."

Grassroots Lobbying

Efforts to influence legislation through an attempt to affect the opinions of the general public or any segment of it is considered "grassroots lobbying." Communication between a 501(c)3 organization and its members with respect to proposed or enacted legislation of direct interest to the organization and its members is not included in the definition of grassroots lobbying. If, however, the communication urges members to contact the legislature or other government representative, or urges members to urge nonmembers to do so, the activity is considered grassroots lobbying.

Campaign Intervention

A 501(c)3 organization may NOT participate or intervene (including the publishing or distributing of statements) in any political campaign on behalf of or in opposition to any candidate in public office. A "candidate for public office" is one who offers himself or herself, or is proposed by others, as a contestant for any elective public office, whether the office is national, state or local. Intervention includes but is not limited to the publication of written or printed statements or the making of oral statements. Certain voter education activities do not constitute campaign intervention, but the scope of this exception is severely limited. In general, anything that reflects a bias in the educational information provided is prohibited.

Cause-Driven Grassroots Activities

Health policy activities that are in synchrony with AACN's vision and health policy priorities are considered to be cause-driven. Members and chapters may be called upon to participate in a national cause-driven issue or agenda that AACN determines to be a priority. In addition, members and chapters may pursue a cause-driven issue or agenda which may not be the same one that is pursued by the national organization.

Member-Driven Grassroots Activities

Health policy activities that a member undertakes, on his or her own behalf, are considered member-driven activities. An example of a member-driven activity might be a member interacting with his or her specific state's water district to promote a clean water supply.


AACN will adhere to the requirements and restrictions for lobbying and campaign intervention imposed by its 501(c)3 tax status.

AACN will participate in lobbying activities but will limit these so they will not be considered to be a "substantial" part of the association's activities.

AACN will not participate or intervene in any political campaign on behalf of or in opposition to any candidate in public office.

Health policy is an important part of AACN's overall agenda. Resources will be applied to the health policy agenda with flexibility to capitalize on strategic opportunities and will be considered within the context of association's annual planning.

The AACN Leadership Team is responsible for setting the framework and determining broad outcomes for the health policy agenda to assure congruence with the mission and priorities of the association.

National priorities of the health policy agenda will be driven by AACN's vision. The Leadership Team is responsible for defining boundaries, if any, for the health policy agenda.

In the context of the organization's mission and vision, AACN will not engage in activities related to labor or union issues.

AACN will maintain a primary focus on the provision of resources for members and chapters to be active and professionally effective in health policy and legislative arenas.

Information and resources provided to members and chapters will be packaged according to a deliberate and consistent process in order to assure information is accurate and user-friendly, addresses complementary and opposing perspectives, and highlights potential areas of conflict in values.

AACN will collaborate as much as possible with other national organizations to address issues that affect professional nursing practice and achievement of AACN's vision.

AACN will be deliberate in the conduct of legal and ethical reviews of the health policy and legislative agenda before responding to issues.

AACN will recognize and support grassroots health policy activities of members and chapters that are cause-driven and member-driven.

AACN will define boundaries, if any, and alternatives for chapter involvement in health policy issues and activities.

AACN will recognize and support national and grassroots strategies that are both proactive (anticipatory to policy) and reactive (responsive to an issue or agenda).

Desired Outcomes

In the context of the definitions and principles set forth above, the following broad outcomes are established for AACN's health policy agenda.

AACN has defined, targeted legislative priorities and strategies to advance these priorities that are directed at achieving the vision and are consistent with the mission, priorities and resource availability of the association. Policy priorities will guide both a proactive and reactive agenda.

Members and chapters will have access to a menu of tools and resources to a) be active and effective in the legislative and health policy arena in order to advance the vision and priorities of the association and/or act on their own personal or professional beliefs and causes and b) influence key decision makers in multiple settings.

The following are examples (based on member needs assessment) of resources to which members and chapters will have access:

  • Motivational or inspirational programs to get members excited about health policy involvement and to know their input makes a difference.
  • Basic and advanced information provided at the right time and in an efficient format.
  • Information on the basic legislative processes such as who and how to contact legislators, how a bill becomes a law, how to work the process to influence an issue, how and when to get involved, and a review of success stories.
  • Programs for development of basic and advanced skills including building and stating a case effectively, quantifying what nurses do, developing relationships with decision makers, and finding and joining coalitions.
  • Linkages to member and nonmember networks and to forums for ongoing dialogue with the association's leadership.
  • Frameworks for deciding on issues, discerning the best role or level of involvement and establishing action plans.
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