Policy Matters Blog

A Bolt of Lightning: Elevator Moments

One of the awesome things about being the father of two boys is that I get to share all the totally radical pop culture elements from my own childhood. I am a child of the 80s, you probably guessed that from use of "awesome" and "radical", don't worry if I make this blog long enough "tubular" is bound to pop up (uh gag me with a spoon) okay I'll stop.

One of the movies we love is Back to the Future, the blockbuster film that made Michael J. Fox a household name in 1985.  In the movie, Fox's character, Marty McFly, travels back 30 years to 1955 in a time machine made from a DeLorean. Unfortunately, for Marty this could be a one-way trip, as he lacks a power source to generate the 1.21 gigawatts of electricity to power the flux capacitor which activates the time circuits (yeah, I've seen this movie a couple of times).  The solution to his predicament emerges from a typically unpredictable source, lightning. This moment in the film conjures up similarities of a recent episode in my own advocacy journey as I attempted to tame policy lightning with a phenomenon known as the "elevator moment".

When I first went to the Public Policy Institute in 2011, I learned about "elevator moments." If you hang around places of power long enough you will undoubtedly bump into powerful people. These moments are often golden opportunities to connect with policy makers. Louis Pasteur is quoted as saying "Chance favors the prepared mind."   Think of the countless times you have ridden in an elevator and how brief these moments are. To take full advantage, you need to have your key message distilled down, so it can be recalled quickly and efficiently.  My fellow NASP GPR colleague from the Southeast, Nikki Sutton, taught me a way to conceptualize this in a very concise and applicable way: "What? So What? Now What?" To illustrate my point, I will use the issue of the  shortage of school psychologists. The first "What?" is the problem or pressing issue, in this case there are far too few school psychologists relative to the needs of students in America's schools.  The second piece, "So What?" addresses the importance of the issue (e.g. many students mental health needs go unmet, hamstringing their success and putting them at risk for a host of negative life outcomes). The final "Now What?" is the solution to the problem moving forward. Advocating for adequate funding to implement federal entitlements in ESSA, IDEA, and Mental Health Demonstration Grants. A great resource for developing key messages on the is the "Effective Communications: Tips for School Psychologists"additional resources for message development can be found in NASP's Policy Playbook.

The elevator moment, with its brief unpredictable nature, epitomizes why key messaging is so crucial, because you often have a narrow window to communicate with decision makers. In Back to the Future, the solution to Marty's predicament (lightning) is also unpredictable. Marty's friend and mentor, Doctor Brown, points out "one never knows where and when it's going to strike."  However, Marty is from the future and realizes that in just a few short days, lightning is going to strike the town's clock tower, disabling it forever. The irony here is that the main characters had a chance to take something that is destructive and chaotic and harness it for good.  In my home state of Kentucky, we also had an impending change in Medicaid policy that was like a brewing storm on the horizon. I found that in a few short weeks I would be given a chance to create my own "elevator moment" and attempt to harness this chance toward the advancement of my profession.

For more than a decade, the federal Centers for Medicare and Medicaid Services (CMS) have allowed local school districts to bill Medicaid for services covered by a student's IEP. In 2014, CMS reversed a long-standing policy granting states flexibility regarding their school-based programs, permitting districts to bill for any health service currently covered by Medicaid inside the school setting for students enrolled in the program. This is great news for school districts like mine, permitting us to recoup some of the cost incurred to provide legally obligated health services we are often not provided adequate funding for. In order to implement this policy, states need to submit a Medicaid state plan amendment (SPA) to CMS. Last year, Kentucky was in the middle of submitting a plan for free care. This was great news, but school psychologists in our state had a problem: many of them would be cut out of this program because Kentucky did not recognize those at the specialist level as a billable provider for Medicaid. If action was not taken to include the profession, a critical opportunity would be missed.  The financial impact alone is enough to deter districts from expanding our role as opposed to a similar provider that is less costly to employ.

My "bolt of lightning" came in the July of 2019, when my superintendent arranged a leadership retreat for district administration at a local college.  This promised to be 2 days of analyzing group dynamics and trust exercises, but the 2nd day was going to have a guest visitor, the Kentucky Education Commissioner. As a favor to the superintendent, the commissioner was coming to talk to our group about his vision for education in our state. I should say at this point that I work in a very small school district, so when I say our entire school leadership was there, that is a group of 10 individuals, so this would be an up close and personal "meet and greet".  It occurred to me what a great opportunity this meeting could be to do serious advocacy. I set about preparing for the often unpredictable "elevator moment."  Utilizing the aforementioned format "What, So What, Now What", I set to the task of developing my key message. The NASP Research & Policy Page was my one stop shop for the "What" portion of my message. There I found information on Medicaid's importance to our profession as well as a list of mental health services school psychologists regularly provide that could be considered "billable".  I also reached out to my colleagues in West Virginia who had successfully navigated a similar encounter involving Medicaid a few years ago. Learning from their experience helped me prepare and understand what would be required for a change in KY's policy.  They were also able to give me some contacts from their state government that I could pass along to the KY Education Commissioner as a resource if he had questions.  Being able to hold up a border state, especially one that neighbored where I live, had the added value of connecting the issue to a real story, my story.  In my conversation with the commissioner I could use myself as a real example and make the point that I could literally cross the river into WV and be a billable provider with my same credentials.  This would be the linchpin of my "So What" portion of my key message. The "now what" or "the ask" as it is called was for him to ensure that school psychologists' status is changed so that they are included in the change to the state's Medicaid Plan.     

The day of the meeting with education commissioner arrived. He met with our group that afternoon for about 45 minutes.  The meeting went well enough, and at the end the commissioner left the room and I followed him out and asked to speak with him briefly. I could tell that my preparation was paying off because in under a minute I delivered on all the areas of my message. At the conclusion of our conversation, he thanked me for making him aware of this problem and asked that I follow up in email with the information we had talked about, which I did that very evening.  In the email I also included some contacts from NASP and WV state government that he could reach out to.

In the climax of Back to the Future, Marty knew instantly he had been successful, as the moment the bolt of lightning hit, he was transported back to the year 1985 in a flash. Regrettably, I didn't have the luxury of a time traveling DeLorean that would allow me to skip ahead to see if I was successful. I was going to have to take the long way to the conclusion of this story and wait.  A couple of months went by and I had begun to resign myself to the idea that I likely would not hear anything. Then, at the start of the school year, I was attending a professional institute put on by our state department of education and the commissioner was the keynote speaker.  At the end of his speech I went to the back of the room to talk to some colleagues during the break. The commissioner must have seen me because he sought me out and thanked me for my email.  He said that he and his team had looked into the matter and were working with the state agency that administers KY's Medicaid Program to make the necessary changes to recognize specialist level school psychologists as billable providers. This was certainly great news and a great victory for kids and the profession of school psychology.  To me, it demonstrates how important it is to get your message concise, and how as advocates for our beloved profession you have to be ready and willing to take advantage of opportunities. After all, lightning never strikes in the same place twice.