The Campaign to Save the Health & Livelihood of Northeast Connecticut

A David Meets Goliath Story and Winner of the 2016 NESHCo Lamplighter Award

Sara Brandon System Director, Marketing Communications, Care New England Formerly Vice President, Marketing Communications, Day Kimball Healthcare

Laura Dunn Director of Marketing and Communications, Day Kimball Healthcare

The Team

Laura Dunn | @QuillAndCursor Laura is the director of marketing and communications for Day Kimball Healthcare, responsible for all aspects of the nonprofit community healthcare system's integrated marketing communications efforts.

With a foundation in journalism and more than 15 years of broad marcomm experience in a variety of industries, Laura has dedicated her career to crafting communications that make a difference.

Prior to DKH she was manager of development and communications for a behavioral health agency, had a consultancy serving the nonprofit, higher education and small business sectors, and even worked at a literal zoo, as public relations manager for Roger Williams Park Zoo in Providence, RI.

Sara Brandon | @BeingSaraLB Sara's career path in marketing communications has included stops at a 60-unit coffee shop chain in Connecticut, Massachusetts and Rhode Island crafting and managing retail promotions that wouldn't slow down the drive-thru; a small agency outside of Philadelphia building visitor traffic for the zoo, selling real estate during the boom and putting people in jobs; running her own communications firm as strategist, writer, designer and chief-cook-and-bottle-washer; a 14-year stint at RDW Group, one of the largest communications firms in New England, where she developed a passion for health care leading accounts for health systems, physician groups, worksite wellness organizations and insurance companies.

She spent three years (and four years prior through RDW Group) at Day Kimball Healthcare as vice president repositioning the 120-year-old hospital as a premier, integrated health network for Northeast Connecticut.

Sara recently celebrated her one year anniversary at Care New England as System Director Marketing Communications. When asked what she does she says, "Fixing health care, doing art and practicing yoga."

Overview | DKH and NECT

Northeast Connecticut (NECT)

13 towns, 450 square miles

Rural, economically disadvantaged area

High Medicaid population

High incidence of chronic conditions

Limited public transportation

Day Kimball Healthcare (DKH)

Nonprofit, independent community healthcare system founded in 1894

NECT’s premier provider of integrated healthcare services, serving 72,000 of 93,000 residents, comprised of: Day Kimball Hospital Day Kimball Medical Group Day Kimball HomeCare Day Kimball HomeMakers Hospice & Palliative Care of Northeastern Connecticut

Region’s largest employer, generating $230 million in annual economic impact

Overview | Hospital Funding in CT

Graph courtesy of Connecticut Hospital Association

CT’s Hospital tax

Established in 2012 as a means to maximize federal Medicaid reimbursement

Through the hospital supplemental payment, state was to return the hospital tax funds in full, plus a portion of the federal matching funds (the state would keep a portion of the general fund as well)

Each year, the hospital tax has gone up while the supplemental payments have gone down

The Challenge

In 2015, Connecticut hospitals faced unprecedented cuts to state funding - twice

Potentially devastating effect on Day Kimball’s operations and services and by extension NECT’s access to healthcare and its economy

Day Kimball was experiencing additional challenges related to: • Multi-year struggling finances • Recent integration of medical group • Due diligence affiliation process underway

Strategy

Elevate Day Kimball’s unique situation as a small hospital without competing with the overall challenges CT hospitals are facing. Coordinate with Connecticut Hospital Association’s campaign to maximize effectiveness. Arm local legislative team with information and tools to gain attention of Governor and fellow state representatives. Maximize Day Kimball’s deep connection with the community.

Tactical Plan

Grassroots public affairs campaign:

• Public pledge/petition drive

• Legislative advocacy

• Earned media

• Social media

• Advertising

• Customize CHA Voter Voice tool with DKH message and remain integrated with statewide campaign

Campaign Phase 1 | April - July

February, 2015 • CT Governor Dannel Malloy releases his

proposed 2016-17 biennium budget which includes:

• reductions in uncompensated care payouts

• a nearly 50% increase in the hospital tax

• elimination of supplemental payments Originally implemented to return the hospitals’ taxes along with a portion of federal matching funds

• elimination of the small hospital fund Provided critical additional funding to community hospitals, including DKH.

• In total, DKH faced $12 million in lost revenue over its next two fiscal years

Campaign Phase 1 | April - July

Build on existing messages • New Day is our story platform for education

on how health care is changing and announcements about changes at Day Kimball

• Your New Day is our e-newsletter distributed

to 16,000+ community members and 1400+ employees

Campaign Phase 1 | April - July

I AM NEW DAY The Pledge is the glue to the campaign. • Engage collective community

ownership to effect change • Educate about Day Kimball’s value

to community • Address impact of state budget cut

proposals on community • Mechanism to catch the attention of

Governor and Legislators

Created in multiple formats • Pads for events and DKH locations • Clip and mail print ad • Online CHA Voter’s Voice • Print from web • Dry erase posters

Campaign Phase 1 | April - July

We went in local press…

Campaign Phase 1 | April - July

We went to the State House with CHA…

Campaign Phase 1 | April - July

We repurposed existing content…

Campaign Phase 1 | April - July

We went on the road…

Campaign Phase 1 | April - July

We went on the air...

Campaign Phase 1 | April - July

We shared on social…

Campaign Phase 1 | April - July

We worked with local media and the community worked for us…

Campaign Phase 1 | April - July

We included our legislators on our team. • Press event, May 14 • More than 2,500 people pledged

Campaign Phase 1 | April - July

We created buzz.

Campaign Phase 1 | April - July

We were rewarded. June 29, 2016

Campaign Phase 2 | September - December

Back at Square One September 18, 2015: Governor Malloy announces $103 million in emergency budget cuts

• $63.4 million in rescissions to hospitals - 100% of hospital funding

• For DKH, a total loss of $5.6 million in FY 2016, likely a total of $11 million through 2017

Campaign Phase 2 | September - December

Within days, we relaunched and reinvigorated our campaign

Facebook feedback: “Done again and again. It is getting more and more difficult to reside in CT and playing around with health services is about as low as you can get. Everyone in the ten town area is at risk for real elimination of services and will have to travel for care. Please contact Malloy and your state reps.” – Debbie Joyal Cyr

Our planned affiliation becomes collateral damage Our campaign serves to illustrate the real and immediate harm caused by the cuts.

Campaign Phase 2 | September - December

Hard decisions call for quick and nuanced communication October 8, 2015: DKH announces $7 million in planned operating cuts • Clear, concise internal communication first • Public announcement quickly followed • High transparency about the gravity of the

situation, balanced with a sense of control

Campaign Phase 2 | September - December

A small victory but it’s not enough; our response must walk a fine line October 9, 2015: • Governor Malloy announces 95% restoration

of the small hospital fund, however the supplemental funding still is not restored

Statement from DKH President and CEO Robert Smanik, stated in part:

“We are very pleased and thankful to the Governor for recognizing the critical importance of restoring these funds to small community hospitals. We are also thankful to our local legislators...

While the restoration of these funds will bring a bit of much needed and welcome relief, it will still only cover about one-third of the roughly $9 million budget gap we face in our 2016 fiscal year, which just began on October 1.

Like all hospitals across the state, we are still faced with the loss of the supplemental appropriation…For Day Kimball, that amounts to nearly $2 million in lost revenue…In addition to the loss of that funding, our hospital tax will increase by about $2 million this year…”

Campaign Phase 2 | September - December

Campaign Phase 2 | September - December

Our transparency & measured messaging pay off Editorial Support from the Norwich Bulletin “Strong leadership is necessary when times are good. But it’s absolutely critical when times are tough. That leadership – preparation for tough times, and making tough decisions when they arrive – is on display now at Day Kimball Healthcare.”

“So on Thursday President and CEO Robert Smanik announced moves that are expected to save $7 million... These are bold moves that will affect many but will limit loss of jobs…”

“Day Kimball’s leaders showed their leadership in the face of crisis. We are pleased that the state did the same. It won’t get Day Kimball out of the woods for good. But it’s a start, and a relief.”

Even under the strain of tough times, our message rings true for our staff Underscores our approach – we are all on the same team.

Campaign Phase 2 | September - December

Campaign Phase 2 | September - December

We continue to make good use of tools & tactics provided by CHA, with a DKH twist

Campaign Phase 2 | September - December

As the battle wore on, we provided a steady stream of insight and context Working the budget battle into other messaging and announcements kept it top of mind and provided ongoing context

Campaign Phase 2 | September - December

“The folks in this part of CT should be very proud of the efforts of these legislators, and for the efforts of DKH and its CEO” – Mary Palmstrom

“Our Governor finally listened. I was beginning to think all the emails were having no effect. DKH is a great hospital and serves the people of NE CT so well.” – Paul R. Desautels

“Such a tremendous effort by all, and such great news.” – Kevin St. Jean

“Thanks to every person who spoke up!” – Elaine Hochberg

“Well done DKH..So proud of you.” – Angela Alabi

Success, celebration and thanks December 9: Partial restoration of supplemental hospital fund • $1.7 million for DKH in addition to the $2.8 million in restored

hospital funding; net loss to DKH is $1.1 million down from the original $5.6 million

Results

Thousands of pledges & petitions Spring - more than 2,600 people sent more than 5,000 paper and electronic pledges Fall – our efforts contributed roughly 10% of the more than 10,000 electronic messages sent to legislators and the Governor

Results

Media coverage was copious and favorable • More than 150 placements

• ongoing, in-depth coverage and supportive editorials by local and reginal papers, as well as some national coverage

• Reached an audience of over 220 million

• Advertising value equivalency of more than $2 million

• Two statewide TV interviews

• Multiple local radio talk show interviews

Results

Social media performance was strong Facebook • 27 campaign Facebook posts over 9 months • 172,131 reached • 3,692 likes • 833 shares • 555 comments • 4,327 clicks through to our online petition and campaign pages • Targeted boosted posts:

• average reach of 16,874 unique users - nearly 20% of our region’s residents

• average click-through rate of 5.16% • generated 6,313 actions and 122 page likes

Results

E-mail provided for a direct line of contact with our most connected audience

Your New Day e-newsletter generated 1,300+ clicks to the online petition and campaign web pages

Results

Website served as an effective hub for information and action During the campaign period, campaign pages • received nearly 4,000 page views • users spent a very healthy average of 2:24

on each page. • This does not include visits to the I AM

New Day online petitions hosted by CHA

Results

The ultimate measure of success:

DKH avoided significant cuts to funding • All $12 million in proposed cuts to DKH were removed from the

final state budget passed in July.

• Subsequent rescissions made in the fall were reduced by about 80%, from $5.6 million to $1.2 million

Beyond the Campaign | DKH Today

One last rollercoaster ride Spring, 2016: The campaign continued during state’s most recent legislative session

• Majority of funding was retained

• More significantly, legislation passed to limit Governor’s power of rescission over hospital funding to 5%

Stronger and moving forward • Renewed appreciation of value and place in

the community

• Strengthened awareness and confidence in unique strengths

• Positive bottom line

Key Takeaways | The Secrets to Our Success

Take a team approach Provide opportunities to get engaged

Key Takeaways | The Secrets to Our Success

Don’t reinvent the wheel – but do customize it • Make the most of limited resources by

dovetailing with others’ efforts and building on existing messaging, whenever possible

• Focus additional tactics on providing the more nuanced communication specific to you and current situation

Key Takeaways | The Secrets to Our Success

Don’t just communicate; educate Provide background and context

Key Takeaways | The Secrets to Our Success

Be transparent • Take them along for the ride

• Builds trust and sense of personal investment

Key Takeaways | The Secrets to Our Success

Know what makes you different and use it to your advantage Understand how those differences translate to strengths and weaknesses; strategize and communicate accordingly so that what makes you different makes you stronger

Questions?