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Massachusetts Health & Hospital Association Ballot Campaign

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The Massachusetts Health and Hospital Association (“MHA”) represents 70 licensed member hospitals across the Commonwealth and plays a critical role in influencing public policy. MHA engaged us to communicate their position to an array of audiences in response to the Massachusetts Nurses Association’s (“MNA”) call for a statewide ballot question on mandated nurse staffing ratios, slated as Question 1 on the 2018 ballot.

Our Strategy

We served as senior strategic advisors, creating messaging and written materials for the campaign, including media advisories, news releases, op-eds and talking points. We employed rapid response protocols and managed all interactions with the media to combat false information in the news, organized and managed press conferences, and strategized and scheduled editorial board meetings with newspapers across the state.

We also built and mobilized a broad and far-reaching coalition of nursing groups, health care organizations, chambers of commerce, community advocacy groups and business organizations to bolster the campaign’s credibility and help build a diverse community of engaged supporters. We activated coalition members to participate in public meetings to educate and persuade residents in their own communities. Using targeted materials produced for each organization, we encouraged coalition members to communicate our campaign messaging both internally and externally, to take part in local editorial boards, and to host their own press events leading up to the election.

Our Results

The “No on 1 Campaign” defeated the nurse staffing ballot initiative, advancing from 30 points behind to winning by an over 40-point margin one year later. The final vote count found 70.4% of Massachusetts residents voted against the ballot question, while 29.6% voted for it.

We secured 23 editorial board endorsements, more than 200 earned media placements and more than 190 letters to the editor and op-eds in media outlets including The Boston Globe, The Boston Herald, Boston Business Journal, Worcester Telegram & Gazette, Bloomberg News, State House News Service, Worcester Business Journal, Cape Cod Times, The Patriot Ledger, The Republican/MassLive, Lowell Sun, The Berkshire Eagle, and The Sentinel & Enterprise.


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