Advocacy During an Election Year: Best Practices and Pitfalls to Avoid


Marc Wetherhorn, NACHC’s former Senior Director of Advocacy and Civic Engagement and current Project Director of Community Health Vote

With the Health Center Funding Cliff looming on the horizon and the election only a few weeks away, this is an ideal time for advocates to ramp up their efforts to make the case for continued support and funding of Health Centers. However, because there is an election underway, it is important for health center to be aware of what they can and cannot do as 501c3 non-profit organizations. The IRS has long-standing restrictions on the advocacy and political activity of 501(c)(3) nonprofit corporations.

To provide some insight into these issues, we’ve invited Marc Wetherhorn, NACHC’s former Senior Director of Advocacy and Civic Engagement and current Project Director of Community Health Vote, to weigh in on some frequently asked questions related to Health Center advocacy in an election environment.

NOTE: This blog is presented for informational purposes only. Please contact a licensed attorney if you have any specific questions or concerns about the political activity at your health center.


Question 1:

As a 501c.3, can I invite candidates to tour our Health Center and meet our staff and patients? Can I invite just the incumbent running for office? Just his/her opposition? Do I have to invite every candidate, even those from “fringe groups”?

501(c)(3) organizations can host candidates or have a legislative breakfast in which politicians come to discuss pertinent policy issues with Health Center staff and board. These candidate appearances are permitted as long as the organization provides equal opportunity to all political candidates seeking office and provides a fair, non-partisan forum. Generally speaking, organizations should extend invitations to all candidates seeking the same office.

Question 2:

How should these invitations be sent out (phone/email)? How much advance should be give? Does it matter?

It does not matter how the invitations are issued; however, it is always wise to have something in writing to describe the event and to document the invitation. Most elected officials and candidates have pretty full schedules, so the more time they are given to try to work your activity into their schedule the better.

Question 3:

Can candidates speak publicly at my Health Center, if for example the press is present? Can s/he talk about the Health Center Funding Cliff? 

Candidates can speak to your staff, board and others and answer questions about their views as part of a visit to educate them about the center and issues important to the center and its patients, but they cannot campaign and shouldn’t be allowed to make a public speech. If the press is present, they can cover the visit and what the candidate says but shouldn’t be allowed to ask questions during the visit.  It should be made clear to the candidate and the press that the visit is only to educate the candidate.

Question 4:

Can our Health Center support or oppose and candidates? Similarly, by being present at our Health Center, does this count as an endorsement of a particular individual running for office particularly if only one candidate makes a personal visit?

No. The IRS completely prohibits all partisan political activity. This means that a Health Center cannot directly, or indirectly, participate in, or intervene in, any political campaign on behalf of or in opposition to any candidate for public office.

Candidate appearances are permitted as long as the Health Center provides equal opportunity to all political candidates seeking office and provides fair, non-partisan forum.  Whether this activity constitutes political intervention will be determined by the surrounding facts and circumstances.

Question 5:

Are candidates allowed to fundraise or distribute campaign literature while at our Health Center? Can we have a policy in place regarding fundraising that we can share with candidates in advance?

No. The same “non-intervention” rules apply as in the previous question. Certainly your center can establish it’s own rules prohibiting this type of activity but they would simply be restating the law.

 Question 7:

What can I, as a Health Center staff/volunteer/board member/volunteer, do on my own time when it comes to endorsing or campaigning for a candidate? How do I distinguish personal conduct from actions undertaken on behalf of the Health Center?

The prohibition on partisan political campaign activity does not apply to the activities of officers, directors, or employees acting in their individual capacity. Staff may work on political campaigns outside work hours, or using their available leave time. However, leaders and volunteers may not use the facilities, equipment, personnel, or other resources of the organization to provide support or oppose a candidate or campaign.

Health Centers would be wise to protect themselves by:

1. Requiring officers or employees acting as individuals engaged in partisan political activity to clearly state that they are acting in their individual capacity, not on behalf of the Health Center, and that any reference to their work for the Health Center is made only for identification purposes.

2. Notifying employees of their limitation on use of their staff time and office facilities. Time sheets should reflect that an employee took leave to participate in partisan activity.

3. Disavowing any partisan actions of officials or employees that appear to be authorized by the organization, taking steps to ensure such actions are not repeated. Such a disavowal should be in writing and done in a timely manner.

Question 7:

What are the rules regarding voter registration at Health Centers?

A Health Center can engage in voter registration activities provided that voter registration is handled in a completely nonpartisan manner. In fact, Health Centers that have out-stationed Medicaid eligibility workers on site (either public employees or Health Center employees with delegated authority) may be required to do voter registration under the National Voter Registration Act, also known as “Motor Voter.”

Question 8: Where can health centers find more information about the rules for engaging in advocacy and political activity?

Health centers looking of more detailed information can go to

Community Health Vote

Nonprofit Vote 

Internal Revenue Service

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