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									                   FEDERAL LOBBYING AND THE LAW:
        A PRIMER FOR STATE AND LOCAL PUBLIC HEALTH WORKERS
                  Directors of Health Promotion and Education
                           1101 15th St. NW Suite 601
                              Washington DC 20005
                                  EMBARGO
                          NOT FOR DISTRIBUTION
                           DHPE MEMBERS ONLY



                            SECTION ONE

   I.                      INTRODUCTION

  II.                     LEGAL LOBBYING

 III.            SUCCESS STORIES OF LEGAL LOBBYING

                            SECTION TWO

 IV.                UNDERSTANDING BOUNDARIES

  V.          UNDERSTANDING POLITICAL RELATIONSHIPS

          MEETING WITH LAWMAKERS IN WASHINGTON AND AT
 VI.
              HOME IN THEIR CONGRESSIONAL DISTRICT

VII.    UNDERSTANDING THE BUDGET/APPROPRIATIONS PROCESS

                              APPENDIX

VIII.                       DEFINITIONS

 IX.                  2 U.S.C. § 1602 DEFINITIONS

  X.                       METHODOLOGY

 XI.                   TELEPHONE INTERVIEWS




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I.     INTRODUCTION

Similar to the traditions of lawmaking itself, lobbying has become part and parcel of a
vibrant and functional representative democracy. Broadly defined, lobbying is simply the
process and practice of influencing government decisions by citizens representing a cause
or opinion. In one form or another, this practice has existed since the advent of law. The
initially unregulated process has been codified into law since 1946 and currently
represents a professional service sector of its own. The law, however, allows for
significant and substantial activity on behalf of constituencies without being restricted by
the legal definition of ―lobbying‖. The law is explicitly written to allow and even
encourage the people of the United States to voice opinions and discuss legislation with
their elected officials, as it is this dialogue that makes for precise and effective policy and
regulation.

Nearly every bill signed into law bears the mark of a lobby. Almost every American
has a lobby in one form or another—the causes or constituencies range from excise tax
regulation to patent restrictions, gun owner‘s rights to global human rights. The
collective effect of all lobbies is a broad and diverse wealth of information surrounding
decision-makers and enabling them to navigate the worlds of the constituencies they
govern. Lobbyists, among other things, are public resources.

Public health lobbying is no exception. Public health officials can and should play an
integral role at every level of policy development and implementation. The reasons are
clear: The government drives policy development, implementation, and regulation of all
health issues. Decisions will be made either with or without the benefit of knowledge,
expertise and information of public health workers who are managing programs --- better
that it be with their input.

Public health professionals can, do and should shape the direction, tenor and substance of
the public health debate within legislative bodies. In the absence of vocal participation
from the public health community, decision-makers are left to decide for them what their
priorities are. Public health decisions will continue to be made with or without a public
health lobby. Thus, it is incumbent upon the public health community to vocalize
priorities to decision-makers in a concerted, prudent and informed fashion.

When public health officials provide data, analysis, and information about the needs,
goals, and outcomes of health programs, they are providing key feedback that enables
effective solutions. This communication with lawmakers is the foundation of any
campaign in the public realm. Public health employees must act as a resource and an
advocate ensuring that public health policies address the heath needs of our communities.

While the importance of lobbying is undeniable, how is lobbying defined within the law?
How does federal law governing lobbying affect health professionals as they seek to
influence decision makers? While allowing latitude for proactive public




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communications, the law on federal lobbying clarifies all that is lobbying, and all that is
not—and thus, what actions can be taken on behalf of the nation‘s public health officials.1




1
  Disclaimer: This paper shall, in no way or interpretation, be construed to constitute legal counsel
regarding educating, advocating, lobbying or lobbying activities at any level of government. Legal counsel
should always be sought to ensure compliance before implementing a policy involving lobbying or
lobbying activities.


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II.    LEGAL LOBBYING

It has generally been accepted that ―educating‖ federal decision-makers is NOT lobbying
and is a safe harbor of permissible activity under Federal law. A half step between
educating and lobbying, is ―advocacy‖, which might be expressed as general support for
a cause without seeking a specific policy outcome or decision. However, neither of the
terms education or advocacy have been defined in law in the context of describing
permissible activity. Lobbying has been defined in law. So for purposes of this paper,
the focus will be defining the term ―lobbying‖, since there exists a more definitive
standard to understand permissible communications with Members of Congress and key
federal officials. However, before we dismiss the terms education and advocacy, the
following guidance is offered that in no way constitutes legal advice, but merely is a
description of common practice.

Educating typically implies the communication of facts, data, reports, studies, program
descriptions, budget information, population impacts, and other information WITHOUT
however making a SPECIFIC recommendation on a piece of pending legislation,
appropriations, regulation or policy decision. Again, practice accepts this conveyance of
factual information to be acceptable in all circumstances from a federal perspective. This
does not mean however, that a state administrative policy may not exist to bar ANY
contact with federal officials. Only that from the standpoint of federal laws, educational
activities are always permitted.

In 2004, members of the Directors of Health Promotion and Education and the Chronic
Disease Directors were solicited to participate in a non-scientific survey to understand
state employee‘s perceptions of educating, advocating and lobbying. Thirty-one
respondents (representing 27 states) participated in the survey which produced some
interesting results. First, with regard to limitations, 66 percent of respondents stated that
there is a federal law that prohibits state employees from lobbying their federal
representatives; however as discussed later, the law only prohibits the use of federal
funds to lobby federal officials. And 43 percent of participants responded that state law
prohibits contact with state and federal representatives regarding policy or funding issues.
One resource to further examine individual state lobbying laws is the Lobbying, PACs,
and Campaign Finance; 50 State Handbook produced by the State Capital Global Law
Firm Group.

Second, with regard to the need to provide information to decision-makers, of the 31
participants, 49 percent said that the use of office funds to travel to Washington, DC to
meet with representatives during an organizations Hill Day was not a way to educate.
This is interesting because respondents felt that 83 percent of decision-makers did not
have enough relevant information to make policy and funding decisions and 91 percent
responded that they could play a more active role in informing decision-makers about
programs. Only 56 percent of participants had accompanied a partner to a meeting with a
state of federal representative while 74 percent said they would accompany a partner, if
asked, to meet with a decision-maker.




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Finally, only 26 percent of respondents said that if an individual or organization
establishes a contract with an outside source to provide federal government affairs and
the outside organization contacts a Member of Congress to discuss federal funding that is
lobbying. However, 74 percent of participants said that a contracted outside government
relations organization would be lobbying if they specifically asked for an increase in
funding.

The results of this survey raise some interesting questions about the role of the state
public health employee in advocating, education and lobbying. The intent of this paper is
to clarify the legal definitions of advocating, education and lobbying and the role of the
public health employee.

Advocating is a gray area that can imply support for a generalized policy such as ―clean
air‖ without recommending a particular standard in law or regulation. Advocacy can be
offered to support immunization as an effective means of controlling disease, without
recommending an increase in population coverage to a specific percentage level or
funding the budget at a specific level – the latter recommendations would be considered
lobbying. Lobbying is recommending a specific policy, law or standard or support or
opposition to such. Advocating to strengthen the public health infrastructure is a vague
goal, and may not be considered lobbying, but recommending a particular budget for a
public health program would be considered lobbying. By walking this line between
advocating and lobbying, individuals may be able to conduct much of the permissible
communication that is needed to affect a decision, without crossing the line that defines
lobbying. Communicating how programs operate and serve the public, the history of
the program budget, the unmet need, may all be viewed as educating, as long as a specific
recommendation is not advanced on a pending decision such as passing legislation or an
appropriation bill.

This basic educational information can build an important foundation of support for a
decision maker to better understand a program or agency, without actually ―lobbying‖ for
the program. It is often this area where state and local public health workers can make
their greatest impact to an education or advocacy without lobbying. Public health
workers who run these programs know them best, and are in the best position to advocate
for them. Unfortunately, they are often gagged from engaging in actual lobbying. The
solution to overcoming this barrier is often the distinction that all lobbying is advocacy,
but not all advocacy is lobbying. Education is typically not considered either advocacy
or lobbying.

To be clear, the above guidance on education and advocacy is NOT legal advice, and is
not addressed in statute. But it has been a commonly understood practice among
organizations engaged in advocacy.




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                    Basic advocacy guidelines for allowable activities

If you are state or local health department employee, there are likely restrictions on who
you may contact in government and what you are allowed to say. Here are some general
guidelines.

Local restrictions may apply

First, check with your supervisor to understand if there is an office policy, state or local
administrative rule or law, or other executive order that establishes what types of
communication you may have with state or federal officials. You may be barred from
having any contact at all, or you may be allowed to provide educational materials but not
allowed to ―lobby‖ in the strict sense of the term. You may be allowed to lobby if on
your own time as a private citizen or member of a professional organization.

Federal restrictions

Second, Federal laws allow anyone to lobby federal officials, but the restriction is that
individuals may not use Federal funds to do so. This means you cannot use federal funds
to pay travel costs if the sole purpose is a lobbying meeting. If your position is 100%
federally funded, you cannot lobby on official time. Federal funds cannot be used to
develop lobbying materials. There is no restriction on ―educating‖ with Federal funds.
Communicating with Federal officials to conduct officials business such as the
administration of grants and contracts is exempted from the restrictions on lobbying.

Requirements to register as a lobbyist

Third, Federal law requires individuals that spend more than 20% of their time as a
lobbyist on behalf of an organization to register with the Congress as a lobbyist.
Organizations that hire lobbyists must also register with Congress, and typically must
report the name of the hired lobbyist on a Lobbying Disclosure Form when the apply for
and receive federal funds in the way of grants, contracts and cooperative agreements.
You are not required to register if you are ―educating‖.




To turn to the term lobbying, ultimately, federal lobbying law defines all legal
communication with decision-makers under one of two categories:

       1) Communication, activity and contact that IS legally defined as lobbying, or
       2) Communication, activity and contact that IS NOT legally defined as lobbying.




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Communication, activity and contact is either one or the other: Never both. And if the
action is considered lobbying under federal lobbying law, the act and the person must be
registered with Congress.

The Lobbying Disclosure Act of 1995 does provide for one restricted population who
cannot legally engage in unrestricted lobbying without consequences: ―An organization
described in section 501 (c)(4) of the Internal Revenue Code of 1986 which engages in
lobbying activities shall not be eligible for the receipt of Federal funds constituting an
award, grant, contract, loan, or any other form.‖2

However, even the 501 (c)(4) groups proscribed above are able to communicate with
covered officials in compliance with the 20 percent rule, which is discussed in the next
section. Thus, all constituencies are legally allowed to communicate with their
representatives in government in a legally definable way.

Explicitly stated, under the 20 percent rule, public health officials may be allowed all
types of communications and contacts with covered officials at the federal level--despite
being funded in part by monies from the federal government to support public health
activities. They just cannot use federal funds for lobbying activities. This means that
they cannot use federal grant funds to travel for lobbying purposes, or the portion of their
salary paid for by federal funds to engage in lobbying. If state policies or laws prohibit
contact with the Congressional delegation, they may be permitted to meet with and lobby
the delegation as a member of a professional organization, and not on behalf of the state
or local health department. Operating well within the constraints of the law, public health
officials can effectively shape and positively address the nation‘s public health policy
issues.




Definitions

Understanding the terminology of the law is the foundation for its application.3 In the
instance of defining lobbying, the germane law is 2 U.S.C. §16024, entitled the Lobbying
Disclosure Act of 1995, and referred to herein as the ―Act.‖5

There are several terms referenced in the Act that serve to clarify the umbrella term
lobbying. Critical among them:


2
  Public Law 104-65, Section 18.
3
  For further clarification, please see ‗Definitions‘ portion of the appendix.
4
  For 501(c)(3) organizations, the germane law is the 1976 lobbying law
5
  PL 104-65, was signed into law by President Clinton on December 19, 1995 and enacted on January 1,
1996.


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         A) Covered Official: The Act defines covered officials as Members of Congress
            and all legislative (as opposed to administrative) staff, and cabinet secretaries,
            executive branch political appointees, and other high-level executive branch
            officials.
         B) Lobbyist: The Act defines a ―lobbyist‖ as any individual who is employed or
            retained by a client for financial or other compensation for services that
            include more than one lobbying contact, other than an individual whose
            lobbying activities constitute less than 20 percent of the time engaged in the
            services provided by such individual to that client over a six month period. 6
         C) Lobbying activity: The Act defines lobbying activity as any action taken in
            support of a lobbying contact, including planning and preparation, research
            intended for use in the contact, and coordination with other lobbyists.
         D) Lobbying contact: The Act defines lobbying contact as any oral or written
            communication to a ―covered legislative or executive branch official‖
            regarding the following matters:

                  1) The formulation, modification or adoption of federal legislation,
                     including legislative proposals, or of executive branch policies,
                     including rules, regulations and executive orders.
                  2) The administration or execution of a federal program or policy.
                  3) The nomination or confirmation of any person who requires Senate
                     confirmation.

The Law in Real Terms

The real effect of the Act has been to increase the number of persons filing as registered
lobbyists, increase public transparency with regards to the quantity and direction of
lobbying, and as a collateral effect, to foster a perception of the Act as an obstruction to
those unfamiliar with the law and its statutory limitations. As the Act itself states:
―Nothing in this Act shall be construed to prohibit, or to authorize any court to prohibit,
lobby activities or lobbying contacts by any person or entity, regardless of whether such
person or entity is in compliance with the requirement of this Act.‖7

However, the Act does, in real terms, restrict the legal boundaries of what public health
officials can do permissibly. The restrictive aspect of the Act with regards to public
health officials is contained in 18 U.S.C. § 1913. This prevents the use of federal funds
for lobbying purposes, as defined by law. The statute reads “No part of the money
appropriated by any enactment of Congress shall… be used directly or indirectly to pay
for … influence in any manner a Member of Congress.” Similar law is stated in Title 31,
U.S. Code, Section 1352, entitled ―Limitation on use of appropriated funds to influence
certain Federal contracting and financial transactions‖ which generally prohibits
recipients of federal grants and cooperative agreements from using Federal (appropriated)
funds for lobbying the Executive or Legislative Branches in connection with a with

6
  With specific regards to associations with public officials employed by states or receiving federal funding,
the ―20 percent‖ rule is arguably the most important exception to the definition(s) of lobbying.
7
  PL 104-65 Section 8 (b)


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specific grant or cooperative agreement. Section 1352 also requires that each person
who requests or receive a grant or cooperative agreement must disclose lobbying
undertaken with non-Federal (nonappropriated) funds.

Thus, the law has established that federal dollars cannot be directly used for activities
defined as a lobbying contact – which include communications on formulation,
modification or adoption of federal legislation, including legislative proposals, or of
executive branch policies, including rules, regulations and executive orders. This law is
generally applicable to state employees whose agencies or programs are the recipients of
federal grants, with certain exceptions. Public health officials retain wide latitudes in
which they can communicate, and in certain cases, strongly advocate their position with
regards to federal policy.

For example, recall that an organization or individual is only considered a lobbyist 8 when
20 percent or more of their compensated time is spent on lobbying activities. Thus, if no
one person in an organization spends more than 19 percent of their time on lobbying
activities, the requirement to register as lobbyist is not triggered.9 In a typical situation
involving a public health association, the purpose of understanding the 20% rule is a
matter of whether or not an organization or an individual has to register as a lobbyist with
the Congress, and it may then also have bearing on the organizations tax status.
Typically, in order to maintain a 501(c)(3) status, an organization cannot use more than
20% of its budget on lobbying or political activity such as campaigning.

As further illustration, let us assume that a public health organization has no employees
that fit the common conception of a lobbyist, but does have a selected member who
sometimes engages in advocacy work on its behalf, aimed at influencing the relevant
regulations or policies of the federal government. If that member makes two or more
"lobbying contacts" and spends more than 20% of his or her compensated time on
"lobbying activities," then that employee will be a "lobbyist." This would trigger the Act
and the organization would have to register, so long as the expenses associated with the
combined "lobbying activities" of that employee and the corporation's non-lobbyists are
above the inflation indexed figure of $22,500.10



8
  Public Law 104-65, Section 3 (10)
9
  The "20 percent rule" is not an organization-wide test. For example, a partner who devotes only 5% of his
or her time to a particular client could be a lobbyist for that client if more than 20% of that 5% was spent in
lobbying activities. Application of the "20 percent rule" can lead to counterintuitive results. Someone who
engages in many hours of lobbying activities may not be a "lobbyist," due to the fact that every hour of
lobbying activities is matched by more than four hours of other paid work performed by such individual for
the organization or "client." Thus, as a hypothetical example, a corporate general counsel might not be a
lobbyist despite having deep involvement in several lobbying efforts, if the volume of general legal work
(i.e., not lobbying activity) he or she handles is sufficiently large. On the other hand, a temporary hire who
performs only a few hours of paid work solely devoted to lobbying (involving two or more lobbying
contacts) may be a "lobbyist," because lobbying activities constituted all of his or her relevant work in the
semiannual time period. Fred- Is this out of another source that should be cited or acknowledged?
10
   Lobbing expenses below this amount are what is known as a de minimis exception. That is to say, the
aggregate sum of expended lobbying monies is not large enough to fit within the scope of the law.


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There are a number of exceptions to the rules of what defines lobbying, and the
applicable rules prescribe the areas in which public health officials can legally operate.
There are 18 exceptions stipulated to clarify that the term lobbying contact does NOT
include certain contacts:11, 12

Some of these relevant exceptions include:

           A) Made by a public official, acting in the public official‘s capacity;
           B) A meeting request;
           C) A written response to a covered official‘s oral or written request for
              information;
           D) A public comment solicited through the Federal Register, Commerce Business
              Daily, etc.;
           E) A statement made public or broadcast through the media;
           F) Congressional testimony;
           G) A petition for agency action;
           H) A legally compelled statement (e.g., subpoena); or
           I) Communications directed solely to the responsible agency concerning judicial
              proceedings and criminal or civil law enforcement matters.

Actionable Items

The Act is, in fact, a tool of empowerment to public health officials as it clarifies what
was previously unclear in the 1946 statutory language. Assuming compliance with the
other provisions within the law, the ―20 percent rule‖ can be an empowering provision
within the Act. In applying the 20 percent rule to one‘s actions, simply take the broadest
possible interpretation of what could be construed as lobbying activities, take the sum of
that time expended over the six month reporting period, and if that sum does not add to
more than 20 percent of all compensated time, you are NOT a ―lobbyist‖, irrespective of
the nature or subject of contact with covered officials.




11
     PL 104-65 Section 3 (8)(B) Exceptions.

12
  Section 3 (9) is, for all intents and purposes, the extent of the applicable portions of the 1995 Act. The
remainder of the Act deals with the requirements for registration, the mechanics of registration, the capacity
for enforcement of the Act, Changes to the FARA Act and amendments to the Byrd Rule. As the readers of
this paper have no intention of entering into the realm of legally definable ―lobbying,‖ these sections of the
Act are not covered in this paper.




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III.   SUCCESS STORIES OF LEGAL LOBBYING

Many public affairs success stories illustrate that, in practice, the Act has enabled
organizations to implement successful strategies within the confines of the law. In
examples below, the barrier to success was not the limitations of the laws of lobbying.
Instead, many state public health departments face administrative boundaries, whether
real or perceived. In many instances, to reduce these boundaries, public health
employees teamed with organizations such as the American Heart Association, American
Cancer Society or a local advocacy group. These partnerships provide public health
employees with a broader range to promote and implement public health policies.

To better understand how state public health department employees used partners to
eliminate or reduce administrative boundaries, members of the Directors of Health
Promotion and Chronic Disease Directors were solicited to respond to a non-scientific
survey. The survey elicited a number of pertinent success stories. The examples
enumerated below can be applied to influence policy and environmental change at the
local, state and federal level.

     A state health department‘s employees were supportive of the introduction of breast
and cervical cancer treatment legislation, but were prohibited by their state administration
from discussing directly with legislators, because it involved funding. To overcome the
administrative boundary, the department teamed with partners such as the American
Cancer Society to educate legislators about the need and benefit of the proposed
legislation. By working through their partners, the department played a vital role in the
successful passage of the legislation. The health department is also playing an important
role by tracking the success of the treatment program.

     A state health department‘s employees played an active role in developing the
framework for a tobacco use access bill, which was ultimately passed by the legislature.
While the department did provide technical support to develop the bill, they were
prohibited from advocating its passage. To overcome the administrative boundary, the
office teamed with local partners to promote the benefits of the bill to decision-makers.
In this situation, the health department was in a unique position of developing proposed
legislation that they would implement if passed. The barrier was the inability to advocate
or explain their reasoning for language within the bill. The health department‘s partners
played an important role in carrying the message to state legislators of the importance of
final passage. Another important lesson learned from this example is that the public
health department raised their profile with state legislators by providing technical
guidance for legislation. This placed the health department in a role as an educator and
as a resource for future initiatives.

     In a similar example, a state‘s health department employees were interested in using
transportation funds to support health initiatives promoting safe routes to schools through
the construction of bike paths, pedestrian walkways and lights. Using health department
partners, the department was able to educate decision-makers on the benefit of funding



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this initiative. In addition to a funding barrier, an initiative of this type had never been
previously earmarked in the transportation package. In addition to successfully
advocating for the passage of this legislation, the health department‘s partners were able
to put the health department on the selection committee for grant applications.

     A state‘s health department initiated an effort to support the doubling of the excise
tax on cigarettes. The health department provided data, fact sheets, research and
communication to employees and partners in the field. However, employees were not
allowed to testify on the benefits of the initiative. To further complicate the issue, many
of the department‘s partners did not agree on the interpretation of the data. To eliminate
the disagreement, the health department hosted meetings on the interpretation of the data.
In this situation, the biggest barrier was the disagreement of the data. Partners can be
powerful allies. However, disagreements among the team can be destructive to the overall
goal. The health department effectively eliminated the misconceptions by creating a
dialogue to understand the differences, eliminating the disagreements in order to present
a united front.

    In another state, an initiative was proposed that would mandate the state health care
coverage of diabetes equipment and education. The health department provided
information about gaps in coverage and how that negatively affected the prevalence of
diabetes. In this situation, the health department faced two boundaries. First, they were
unable to provide decision-makers with the information they produced unless it was
requested. And second, there was a general public perception that they were too many
mandated health benefits. The health department worked with their partners to
disseminate the information that ultimately eliminated the perception that the state did not
need another mandated health program.

     A state‘s health department supported the passage of a mammogram quality
standards initiative. The health department had the data to illustrate the poor quality of
the current standards, but they faced a boundary of there being no precedent for this type
of law within the state. Working with partners, the department gathered support to
influence final passage of the bill. Additionally, supporters of the initiative used the
media to increase the visibility of the health problem. In this example, the health
department and their partners used the power of the media to increase the visibility of the
situation without frightening the public.

      A state‘s health department created and implemented a mandatory physical activity
initiative within the school system to address youth obesity. This was accomplished by
helping to create, organize, and give administrative support and grants to a school health
alliance. The health department also worked to ensure that a health department
representative was appointed to the board, which was a barrier because some considered
name a health department employee a conflict of interest. To move their agenda, the
health department partnered with the Department of Education, school districts,
Medicaid, and the American Cancer Society and American Heart Association.
Managing, coordinating and communicating with a large group can be challenging.
However, this internal policy initiative was successful, because the focused agenda was



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pushed forward, not the people involved or their competing agendas. This type of
initiative also gives the health department another vehicle to promote health policy and
environmental change.

     Another state health department‘s obesity initiative focused on the elimination of
vending machines in schools. The health department provided the information to
relevant groups who educated and advocated for the removal with decision-makers. One
boundary was state officials‘ reluctance to interfere with a local issue. Ultimately, the
partners convinced the legislature that eliminating vending machines in schools was the
best policy. In this situation, partners had to ensure that the right people were educated
on the health benefits of removing the vending machines. In most cases, it requires many
attempts before the correct person is identified or original contact takes place.

     During a state‘s budget debate, the Governor proposed a reduction in the health
department‘s tobacco cessation program. State health department employees are
prohibited from publicly opposing the Governor‘s budget. To eliminate this boundary,
the health department used their partners to disseminate information to the legislators and
constituents about the benefits of the program. The final approved budget included full
funding for the tobacco program.

Lessons Learned

In the examples above, the state employees understood their perceived and actual
administrative boundaries and looked for an alternate way to participate in implementing
public health and environmental policy change. In all cases, state employees sought
partnership or organizations that were equally supportive of the policy initiatives led by
their office. In the survey, 74 percent of respondents reported developing documents that
enhance the mission of their partners. Of that percentage 96 percent of respondents say
their material is presented to government officials.

Second, in many cases the departments tracked the success of the implemented policy.
Federal and state decision-makers are driven by current budget cycles. It is important for
them to not only understand how a program impacts their constituents‘ health, but the
cost-savings to the government for implementing the program. Funding, whether through
the state or federal budget, is likely to always be a barrier for implementing or increasing
public health policy initiatives. Tracking current policy programs to understand their
financial impact on Member of Congress‘ constituents can be a valuable tool to educate
decision-makers on the value of the program. A very successful tool is to issue program
reports that provide descriptions of the program, accomplishments, and needs. Yet
another approach is to develop action plans or strategic plans that may require additional
resources to implement. Once these documents are developed, partners can help relay
this important information to decision-makers.

One of a state public health employee‘s strongest partners can be a legislator at the state
or federal level. These decision-makers ultimately determine the policy directions and
funding levels for offices and programs. By developing a relationship with them and



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their staff, you present an opportunity for you and your office to become a valuable
resource to them. Also, state legislators often take up advocacy for an issue, and they
may in turn become the lead advocate to their federal counterparts in Congress – urging
them to provide additional federal resources or laws to address a local issue.



Success Story Tips

 State public health department employees are educators and communicators. It is
important to develop a message and that it be communicated consistently from program
leaders to the volunteers in the field. Before engaging new partners, understand potential
partner differences and potential conflicts. This will facilitate the elimination of message
confusion later in the process.

 Build a trusting relationship with your partners and continue to seek new members to
increase your partner coalition. Groups may not agree on all issues all of the time.
However, determining a common ground on an issue will strengthen your grassroots
advocacy.

 Motivate partners by acknowledging their time and dedication to the issue. This can
be as simple as a thank you letter or an award from the department.

 Don‘t be afraid to engage professional government affairs counsel. A knowledgeable
government affairs or lobbying firm can help partners prioritize issues and organize a
legislative strategy even if the firm is not engaged in direct lobbying.

 Convey the department‘s expectations of the initiative as well as the role of your
partners. Understand your partner‘s expectation and be prepared to negotiate to achieve a
common message.

 When partners designate an organization point of contact, make sure it is a good fit
for the Member of Congress or state legislator. For example, the point of contact should
either be a voter in the district or has a direct personal relationship with the legislator.

 When working with a Member of Congress, partners‘ points of contact should do the
following:

                Distribute and explain relevant information to the legislator and staff;
                Provide information about how the program will impact the local
                 community:
                Participate in the legislator‘s activities, including town meetings and
                 political events;
                Be the first to share both bad and good news with the legislator and
                 staff; and



                                                                                         14
                Host events that provide an opportunity for the legislator and staff to
                 meet state health department representatives.

 Don‘t focus on obstacles. Break down your plan so that you can find solutions for
each boundary.

 Never say ―I can‘t.‖ It is easy to say ‗this task can‘t be accomplished.‘ Make sure the
plan addresses all potential problems that may be presented internally, from your
partners, or from outside sources.

 Find a champion. Determine which decision-makers are interested in your issue.
Ideally it will be a legislator who sits directly on the committee of relevance, but that is
not always possible. Even a champion that is not on the ―right‖ committee, but who but
one that just cares about your issue can be effective.

 Build coalitions. Coalitions and partners should include different agencies,
organizations and legislator champions. There is significant power in partnerships to
influence decision-makers.

 Understand the politics of the issue. It is important to understand the public‘s
sentiment. Often, there are a few voices that are most vocal to support an issue for the
common public good. Decision-makers are more likely to support an issue if there is a
united front.

 Understand the budget. State and federal budget deficits make it harder for decision-
makers to support programs. Decision-makers must be educated on the cost-benefit
equation of the program.

 Make your information relevant. Tailor your message so that it is relevant to your
audience. Decision-makers need to know additional information about your program
such as the cost-benefit analysis, population served, and how additional funding will
support the program to provide additional benefits.

 Be patient and persistent. It takes time and perseverance to enlist, engage, and
activate decision-makers.

 Don‘t be intimidated. Develop a strategic plan that breaks down the necessary tasks
so that you fully understand the obstacles and have time to develop alternative solutions.

 Look for other opportunities to support the initiative. Determine whether another
agency might be better able to secure resources and decision-makers‘ support for
implementation. Know your partners‘ relationships. They may be able to provide other
strategies and solutions.




                                                                                           15
 Make friends with the media. The media is a powerful tool and should be used in
your strategy. Information should be informative, but it is usually counterproductive to
use scare tactics to gain support.

 Build in milestones and measurements within your strategic plan. Developing and
implementing public policy and environmental change is a long process. Proposed
legislation is often introduced and re re-introduced in multiple legislative cycles before it
is finally acted upon.

 Support your partners‘ grassroots. It takes significant work to educate, coordinate
and motivate grassroots advocacy. Often people underestimate their power to play an
important role in the process. Continue to educate on the importance of involvement to
help partners grow their grassroots.




                                                                                           16
IV.    UNDERSTANDING BOUNDARIES

In many cases, the biggest boundaries faced by state health department employees are the
administrative boundaries implemented by the Governor‘s office and state agency
leaders. The following is a list of potential questions that state health department
employees should ask when trying to eliminate or reduce the administrative health
boundaries.

 What is the administration’s policy on interaction with legislators? Can I proactively
advocate and educate?
Typically, the governor‘s administration changes every four to eight years. However, the
perception of a state employee‘s role may not be questioned when an administration
change occurs. For example, 20 years ago a governor told his cabinet secretaries that
their employees were not allowed to make contact with any state or federal legislators.
Twenty-years later no state health employees have sought to update the rule. Thus they
are still following this mandate, passing up opportunities to proactively educate decision-
makers by participating in forums or organized trips to Washington, D.C.

 Can partners really help influence state and federal legislators?
The simple answer is yes. Partners can be anyone you work with collectively to achieve
a common goal. Partners are fellow agencies, outside organizations, individuals and even
legislators. Partners may perform tasks that are prohibited by a health department
employee, such as advocacy. It is critical to develop a trusting relationship with your
partners as they become the face of the issue you are ultimately supporting. Trust also
allows you to eliminate any differences of opinion and to work together in a collaborative
manner. Partners can provide the following:

              Access to personal testimony of how a public health program has
               impacted an individual and their family‘s life;
              A grassroots advocacy network to contact and influence both state and
               federal decision-makers;
              Information provided directly to decision-makers through letters, events,
               telephone calls and personal meetings; and
              An opportunity to facilitate through a meeting, roundtable, or conference
               for decision-makers to be exposed to your expertise.

 Does it matter when a health policy initiative is launched?
Timing is very important. It is self-defeating to announce a health campaign that will
save many lives but cost the state more money during the same week it is announced the
state is in a financial crisis. However, announcing a campaign that will save state funds
would be most appropriate at precisely this time. Funding will always be an issue. It is
important for the department to set their priorities internally so during a financial crisis
partners are not confused or discouraged by internal conflicts.

 Do decision-makers and their staff really care to listen to the information provided by
a state public health department employee?


                                                                                           17
Absolutely. One person can influence the opinion of a decision-maker. Information in
the right hands can be a powerful tool. Decision-makers and there staffs are confronted
by many issues throughout the day. They rely on the knowledge and expertise of those
professionals in the field to educate them. State health department employees may face
restrictions on being proactive in supporting their programs, but they are allowed to
develop relationships with legislators who may call on them at any time.

 How do I develop a relationship with decision-makers and their staff?
State health department employees can work with their partners to be introduced to
decision-makers as experts in the field who are available for use as a resource. This can
be done through an event a decision-maker attends or though meetings scheduled through
partners and other organizations.

For example, the state director of cardiovascular program attends a public health
association‘s conference in Washington. D.C. The director is prohibited by a governor‘s
mandate from directly calling her delegation. During the conference, the organizers
make time for attendees to visit with their delegation. The organizers recognize the
contact prohibitions on many of its attendees and offer to schedule meetings for those
who are interested. The organization schedules a meeting for their professional staff and
includes the director from the state. Thus, the director is able to meet with her delegation
to explain her programs and the organization is able to specifically advocate for a funding
increase.

 What information is important to decision-makers?
It is important to tailor all information to the audience receiving it. Decision-makers care
about public health programs, but are most often influenced by the bottom-line of the
budget. It is important to explain the following:

                  Current budget, the budget being sought for next year, and out year
                   budget estimates;
                  What the program will accomplish;
                  Who will be served;
                  Specifically how the money will be spent;
                  Who supports the program;
                  The science supporting the benefits of the program; and
                  The cost-benefits of implementing or continuing the program.

For example, an obesity initiative is requesting additional funding for the fiscal year. The
initiative has received favorable support of decision-makers because partners collectively
provide the same answers to the above questions.

Decision-makers and their staff have little time to devote to every issue they face. It is
beneficial to present information in a concise, clearly stated one-to two-page paper.

 What can a health department employee say in a meeting with a Member of Congress?



                                                                                             18
State employees may be prohibited from advocating for their programs, but they can
illustrate scenarios during meetings with their legislators. For example, it is within a
public health department‘s role to understand how a federal cut in funding will impact
their program and explain that to decision-makers who represent the impacted
constituents.




                                                                                           19
V.     UNDERSTANDING POLITICAL RELATIONSHIPS

Understanding the depth and breadth of an organization‘s political capital is key to
successfully using that capital.

Scenario: Every morning George Barnes spends five minutes admiring his rose gardens
while talking to his neighbor who is also admiring his roses before heading off to work.
In addition to being a dedicated horticulturist, George is a cancer survivor. George and
his wife volunteer for events with the local American Cancer Society. He also talks
regularly about the need to find a cure for cancer with his neighbor, Congressman Bob
Kaufman. George uses the information he receives from the state health department and
American Cancer Society when he talks about finding a cure for cancer, but he has never
specifically provided his neighbor and Congressman with a plan on how increasing
cancer funding will impact him and his cause.

George Barnes is in a unique situation on two fronts. First, he is a cancer survivor and
knows first-hand the benefit of funding cancer research. Second, he has a personal
relationship with a friend and neighbor who is in a political position to influence funding
for cancer programs.

George and many people like him are interested in supporting causes based on their
personal experiences. However, other than talking in general terms about the issue, they
are unsure what to say specifically. Partners play an important role in training and
educating their staff and volunteers to communicate an effective message to legislators
whether during an official office visit or during a personal visit. The first step is learning
more about the people working with you.

A simple survey of staff and volunteers can produce a datasheet of potential political
contacts.

Coalition for XYZ Political Survey
Name                                          Staff or Volunteer
Address                                       Telephone Home:
                                              Work:
                                              Cell:
E-Mail                                        Occupation
Name of Official or staff contact, title and office
How do you know?           How well do you know?
                         Very Well        Well      See Occasionally          Acquaintance
Business _________             __           __             ___                   ___
Personal _________              __           __             __                   ___
Family _________               __           __             ___                    ___
What is the best way to contact you?




                                                                                            20
VI.  MEETING WITH LAWMAKERS IN WASHINGTON AND AT HOME IN
THEIR CONGRESSIONAL DISTRICT

A constituent meeting with their legislator is a fundamental underpinning of how a
representative democracy works. Members of Congress want to hear from their
constituents and local officials. This is an opportunity to influence your legislator‘s
decision on policy or to provide general education material about an issue that is
important to the state. Constituents that want to talk about national issues or topics in
their local community can become powerful activists if they are organized and prepared.
Individuals and groups who are forthright and concise in their statements and beliefs can
have a positive affect upon their lawmaker.

Before you schedule a meeting, you should be focused and understand your objective.
Clarity on precisely what you want is paramount. Below are tips on how to achieve a
clear and precise meeting:

Do your homework. It is important to understand the issue you are presenting to your
legislator and their staff. This includes the history of the issue, who will be impacted,
and if there is a financial cost to the government or local community.

Determine who will lead and attend the meeting. Congressional office space is often
limited. It is important to keep in mind that your Member of Congress will also be joined
by staff members. Keep the group size to a number that can easily participate in a
conversation. Designate a spokesperson to introduce fellow members in the group and
to lead the presentation.

Prepare your presentation. The information presented during the meeting should be
accurate and concise. It is important to remember that Members of Congress and their
staff have busy schedules. With regards to the overall meeting, it should be considered a
timed presentation. Your presentation should be planned to last 15 minutes – you may
have the opportunity to go longer or you may be allotted less time. The key points of your
discussion should be covered early on---the more specific the better. Make your most
important points clearly, succinctly and specifically. Use a conversational tone in your
presentation, and don‘t be defensive or argumentative.

Prepare a fact sheet. A brief fact sheet should complement and supplement the material
presented during the conversation. It should consist of facts and clearly state the
objective sought by the group.

Know your audience. Know who you are talking to, what they do and what you want
from them.

Be concise. Be prepared and equipped to state the reason for your visit; if you want
action taken, explain what action is needed, when, for whom, and why.




                                                                                            21
Scheduling a Meeting

Before discussing your issue with a Member of Congress, you first have to schedule your
meeting through the staff. If you are unsure who your Member of Congress is, you can
look in the White Pages under U.S. government or via the internet at U.S. House of
Representatives (www.house.gov) or the U.S. Senate (www.senate.gov).

It is important to remember that you do not have to travel to Washington, D.C. to meet
your Member of Congress. Often, your legislator will be back in your district on Friday,
Saturday, Sunday, and Monday as well as most ―congressional recesses‖ that take place,
holidays or in summer and winter breaks. Most Members of Congress usually have
several district or state offices. In addition, they might hold frequent town hall
meetings—an ideal opportunity to express your opinions on issues that face the
community and the nation. If you are unable to schedule an available time with your
Member of Congress, you may be asked to meet with the Legislative Assistant, Chief of
Staff, or other staff person. You should never discount the importance of staff.
Remember, they do the behind-the-scenes work that makes your Member of Congress a
distinguished leader.

When you call the Washington D.C. office, you should ask to speak with the ―scheduler‖
who will want to know why you want to meet with your legislator. Be polite but
persistent in trying to set up a meeting. Be prepared to name those who will be attending
the meeting. You may be asked to fax a written request. In addition to the Member of
Congress‘ daily responsibilities, the scheduler receives many constituent meeting
requests. It is vital to prioritize and limit the request you make of the Member of
Congress.

You may telephone your Senators or Representatives through the U.S. Capitol
Switchboard at 202-224-3121. Keep in mind that due to increased security, mail through
the U.S Postal Service to your legislator in Washington could be delayed as long as three
months. E-mails directly to staff members and faxes are the current preferred method for
communication.

If you are scheduling multiple meetings during the day, then it is important that visits are
planned with sufficient time. Members of Congress and their staff are often very busy
with schedules regularly interrupted by urgent, unscheduled events. Be patient. To allow
time to get from one place to another and to account for possible late meetings you
should expect dead time between meetings. Allow time to travel from office building to
office building. Allow plenty of time to walk or cab from the ―House side‖ to the
―Senate side‖ and vice versa, which can take 20 minutes.

If you are meeting in a Federal building, be prepared to be screened by security, similar
to that at an airport. To move through security quickly, do not carry unnecessary
electronic equipment or metal items. It is not unusual to wait 15 minutes in security lines
at the door of Congressional office buildings.




                                                                                          22
Meeting with a Member of Congress and their Staff

There are several key components to having a successful meeting with your Member of
Congress. First, it is important to be a good listener. You may be unfamiliar with
legislation that the Member has previously supported so don‘t pretend you are familiar.
Ask direct questions if you‘re genuinely curious. Don‘t be afraid to be direct with such
questions as, ―Can we count on you, Congressman, to cosponsor this bill? This would
really help our community.‖ You should try to relate a personal story which highlights
your experience with the issue and why you care about it. Relate local information and
facts about how the issue or the Federal program/intervention impacts local constituents.

It is also extremely important to write down all information that you learned about the
legislator‘s position so you can share it with others in your partnership. Finally, if any
staff attends your meeting, be sure to get their name and contact information to provide
them with any additional information or updates. Do not be shy about sending the staff
periodic updates. The staff keeps the Member of Congress informed on your issue and
activities. It is important to remember that legislators have many demands on their time
and schedules – your number one interest may not be their number one interest.

What To Expect During a Meeting

• Meetings on the Hill can take place anywhere – in a Member of Congress office, in a
Committee Hearing room, in the reception area, in the hall, or in the cafeteria. Space is
limited on the Hill so be prepared to make your presentation in any environment.

• Expect interruptions, tardiness, cancellations and rescheduled visits. Members and their
staff are juggling many responsibilities during the day. Anticipate changes in whom you
may meet with.

• Expect a neutral reaction – Members of Congress and their staff rarely make firm
commitments on the spot. A favorable response is a commitment to ―do the best
possible.‖ A more likely response is to ―consider‖ the proposal.

• Don‘t be surprised by a lack of interest or negative response. Don‘t respond in an
argumentative manner to a negative reaction.

• Express appreciation to the person you are visiting for the time spent and the
opportunity to present your issue.

• If you are asked to provide additional information, make sure you understand exactly
what the staff is requesting and provide it to them promptly. Remember that regular mail
is not a preferred method of delivery due to security concerns. Ask if the information
should be provided by e-mail or fax.




                                                                                            23
• Dress nicely. Your clothes should be clean, pressed and conservative. Your appearance
should not detract from your message. Arrive on time and introduce yourself to the
receptionist.

• A nice firm handshake and smile to your legislator and their staff during your initial
greeting and exit are important.

• Offer business cards at introduction. Explain any professional affiliation or
background.

• Express your main point and request for the purpose of your visit at the beginning of the
meeting.

• Take notes and report key statements of support or concerns of the Member of Congress
or staff to your national organization and/or coalition partners if appropriate.

• Thank your member and staff for their time even if he or she does not agree with your
position. Never threaten them.

• Write a follow up thank you letter in a prompt manner. This is an opportunity to
continue to build a relationship with your elected official and his or her staff. You should
outline the different points covered during the meeting.

• Never underestimate your importance.




                                                                                           24
VII.   UNDERSTANDING THE BUDGET/APPROPRIATIONS PROCESS

Each year, Congress writes and passes 11 basic Appropriations Bills that fund the entirety
of the government‘s discretionary spending. Whether the expense is the budget for the
Centers for Disease Control and Prevention or the Pentagon — every discretionary penny
must be approved by Congress through these 10 bills every year.

The yearlong process of reviewing the President‘s budget request and allocating
resources to agencies that then obligate funding is collectively known as the
congressional appropriations process. This unique procedure is one of the most time-
honored and politically involved in Washington.

The appropriations process commences on the first Monday in February, when the
President‘s budget request is submitted to Congress for the federal fiscal year that begins
on October 1st of the year. Before the appropriations bills are marked up, Congress is
supposed to pass a budget resolution that is developed by the Budget Committee. The
budget resolution does not become law, but establishes an overall spending blue print to
guide the development of appropriations and authorization bills during that session of
Congress. Among other things, this House and Senate passed budget resolution serves as
a limit for discretionary federal spending. These limits are referred to as a ―302 (a)‖
allocation (referencing section 302(a) of the Budget Act), and is the top-line aggregate
spending limit the Committee on Appropriations can spend during the session among all
11 spending bills. Each appropriations subcommittee then receives a ―302(b)‖ allocation
for its specific jurisdiction, which limits how much that subcommittee can spend on all
programs under its jurisdiction. The Labor, HHS, Education appropriations bill had a
302(b) allocation of approximately $140 billion in FY 2005. When the subcommittee
drafts its FY 2006 appropriations bill, their decisions and ability to provide budget
increases will be limited by 302(b) allocation it has to work with. If the allocation is a
$3 billion or $6 billion increase over the prior year, or a $3 billion cut below the prior
year, will force decisions as all 500 programs that are funded in that bill essentially
compete for a share of the zero-some funding that is available.

Working within the confines of the ―302(b)‖ limits, each of the appropriations
subcommittees officially begins consideration of its respective bills in the late spring.
Consideration consists of program and account evaluation as well as prioritization of
funding initiatives. Subsequent to the consideration of the 11 bills, the subcommittees
and full committee mark-up their bills before reporting them to the House and Senate
floors for votes. Once beyond the potentially contentious mark-up and floor
consideration of each chamber, the bills are referred to House-Senate conference
committees, where differences in spending levels and language between the chambers are
reconciled by the selected House-Senate conferees, which are typically the members of
the subcommittee for that particular bill. These conferees are charged with producing the
final conference report for the bills, which are subsequently approved again, by the Full
House and Full Senate, and sent to the President for signature or veto. After being
signed, the enacted legislation enables the Treasury to begin funding Agencies, programs
and projects.



                                                                                        25
The content of these bills, to varying degrees, reflects the priorities of the Administration
and Members of Congress, both of which are influenced by the advocacy efforts of
constituents, lobbyists, and non-profit and for-profit businesses, organization and
associations. Input is received by hearings, letters, emails, phone calls, office meetings,
reports, the media, site visits, and other means. Especially on the legislative branch side,
the process is designed to provide opportunity for public comment and input. Those in
the public that take of advantage of this opportunity, have a better chance of ensuring
their view point is at least considered. Those that do not participate are relying on
someone else to look out for their interest, which may not always happen. Congress is a
busy body, and expects information to flow the Members and staff. They don‘t have the
investigative resources to go to collect information and perform studies or analysis to
ensure that decisions are based on all available information.

All 11 spending bills are supposed to be passed by the beginning of the new fiscal year
on October 1. However, if the bills are contentious and therefore difficult to pass on
time, continuing resolutions are often passed for short-term, finite periods in order to
continue government operations and avoid a shutdown. Working under deadline of the
continuing resolutions, the committees often bundle the un-passed spending bills into a
catch-all bill, called an omnibus appropriations act.




                                                                                          26
VIII. DEFINITIONS

The following definitions are provided as a reference for terms used in this paper.

Advocacy: the act or process of supporting a cause or proposal.

Affiliated Organization: any entity other than the client that contributes in excess of
$10,000 toward the registrant's lobbying activities in a semiannual period, and in whole
or in major part plans, supervises, or controls such lobbying activities.

Appropriations: public funding provided for a specific purpose.

Chief of Staff: a congressional staff member who reports directly to the member of
Congress. He/She usually has overall responsibility for evaluating the political outcomes
of various legislative proposals and constituent requests. He/She is also in charge of
overall office operations, including the assignment of work and the supervision of key
staff.

Congressional Delegation: a person or group of persons officially elected or appointed
to represent another or others.

Covered Official: high ranking executive and legislative personnel covered under law as
a lobbying contact.

Legislative Assistant: a congressional staff member responsible for monitoring and
advising the Member on one or more specific policy issues. Depending on the
responsibilities and interests of the member, an office may include a different LA for
health issues, environmental issues, taxes, etc.

Legislative Correspondent: A congressional staff member who assists the Legislative
Assistant, who is usually responsible for answering voluminous constituent mail, in
addition to other duties.

Legislative Director: a staff member who manages the legislative staff, monitors the
legislative schedule, and makes recommendations regarding the pros and cons of
particular issues.

Legislator: Member of a legislative body, whether at the state or federal level.

Lobbying Activities: Lobbying contacts and any efforts in support of such contacts,
including preparation or planning activities, research and other background work that is
intended, at the time of its preparation, for use in contacts and coordination with the
lobbying activities of others.




                                                                                         27
Lobbying Contact: Any oral, written or electronic communication to a covered official
that is made on behalf of a client with regard to the enumerated subjects at 2 U.S.C. §
1602(8)(A). Note the exceptions to the definition at 2 U.S.C. § 1602(8)(B).

Lobbying Firm: A person or entity consisting of one or more individuals who meet the
definition of a lobbyist with respect to a client other than that person or entity. The
definition includes a self-employed lobbyist.

Lobbying Registration: An initial registration on Form LD-1 filed pursuant to Section 4
of the Act (2 U.S.C. § 1603).

Lobbying Report: A semiannual report on Form LD-2 filed pursuant to Section 5 of the
Act (2 U.S.C. § 1604).

Lobbyist: Any individual who (1) is either employed or retained by a client for financial
or other compensation (2) for services that include more than one lobbying contact; and
(3) whose "lobbying activities" constitute 20 percent or more of his or her services on
behalf of that client during any six-month period.

Member of Congress: Person elected to either the U.S. House of Representatives or the
U.S. Senate.

Partners: Partners can be anyone you work with collectively to achieve a common goal.
Partners can include fellow agencies, outside organizations, individuals and even
legislators.

Person or Entity: Any individual, corporation, company, foundation, association, labor
organization, firm, partnership, society, joint stock company, group of organizations, or
state or local government.

Public education: the action or process of providing an individual or group with
information— in short, to inform.

Registrant: A lobbying firm or an organization employing in-house lobbyists that files a
registration pursuant to Section 4 of the Act.

Scheduler: the congressional staff member responsible for allocating a member‘s time
among the many demands that arise from congressional responsibilities, staff
requirements and constituent requests.

Staff Assistant: a congressional staff member who manages various responsibilities for
the Member including drafting of letters, Capitol tours, managing the Members telephone
calls and mail correspondence.




                                                                                        28
IX.    (2 U.S.C. § 1602) DEFINITIONS , Lobbying Disclosure Act of 1995

§ 1602. Definitions

As used in this chapter:
(1) Agency
        The term ―agency‖ has the meaning given that term in section 551 (1) of title 5,
        United States Code.
(2) Client
        The term ―client‖ means any person or entity that employs or retains another
        person for financial or other compensation to conduct lobbying activities on
        behalf of that person or entity. A person or entity whose employees act as
        lobbyists on its own behalf is both a client and an employer of such employees. In
        the case of a coalition or association that employs or retains other persons to
        conduct lobbying activities, the client is the coalition or association and not its
        individual members.
(3) Covered executive branch official
        The term ―covered executive branch official‖ means—
                (A) the President;
                (B) the Vice President;
                (C) any officer or employee, or any other individual functioning in the
                capacity of such an officer or employee, in the Executive Office of the
                President;
                (D) any officer or employee serving in a position in level I, II, III, IV, or V
                of the Executive Schedule, as designated by statute or Executive order;
                (E) any member of the uniformed services whose pay grade is at or above
                O–7 under section 201 of title 37; and
                (F) any officer or employee serving in a position of a confidential, policy-
                determining, policy-making, or policy-advocating character described in
                section 7511 (b)(2)(B) of title 5.
(4) Covered legislative branch official
        The term ―covered legislative branch official‖ means—
                (A) a Member of Congress;
                (B) an elected officer of either House of Congress;
                (C) any employee of, or any other individual functioning in the capacity of
                an employee of—
                        (i) a Member of Congress;
                        (ii) a committee of either House of Congress;
                        (iii) the leadership staff of the House of Representatives or the
                        leadership staff of the Senate;
                        (iv) a joint committee of Congress; and
                        (v) a working group or caucus organized to provide legislative
                        services or other assistance to Members of Congress; and




                                                                                            29
               (D) any other legislative branch employee serving in a position described
               under section 109(13) of the Ethics in Government Act of 1978 (5 U.S.C.
               App.).
(5) Employee
       The term ―employee‖ means any individual who is an officer, employee, partner,
       director, or proprietor of a person or entity, but does not include—
               (A) independent contractors; or
               (B) volunteers who receive no financial or other compensation from the
               person or entity for their services.
(6) Foreign entity
       The term ―foreign entity‖ means a foreign principal (as defined in section 1(b) of
       the Foreign Agents Registration Act of 1938 (22 U.S.C. 611 (b)).
(7) Lobbying activities
       The term ―lobbying activities‖ means lobbying contacts and efforts in support of
       such contacts, including preparation and planning activities, research and other
       background work that is intended, at the time it is performed, for use in contacts,
       and coordination with the lobbying activities of others.
(8) Lobbying contact
               (A) Definition
               The term ―lobbying contact‖ means any oral or written communication
               (including an electronic communication) to a covered executive branch
               official or a covered legislative branch official that is made on behalf of a
               client with regard to—
                       (i) the formulation, modification, or adoption of Federal legislation
                       (including legislative proposals);
                       (ii) the formulation, modification, or adoption of a Federal rule,
                       regulation, Executive order, or any other program, policy, or
                       position of the United States Government;
                       (iii) the administration or execution of a Federal program or policy
                       (including the negotiation, award, or administration of a Federal
                       contract, grant, loan, permit, or license); or
                       (iv) the nomination or confirmation of a person for a position
                       subject to confirmation by the Senate.
               (B) Exceptions
               The term ―lobbying contact‖ does not include a communication that is—
                       (i) made by a public official acting in the public official‘s official
                       capacity;
                       (ii) made by a representative of a media organization if the purpose
                       of the communication is gathering and disseminating news and
                       information to the public;
                       (iii) made in a speech, article, publication or other material that is
                       distributed and made available to the public, or through radio,
                       television, cable television, or other medium of mass
                       communication;




                                                                                          30
(iv) made on behalf of a government of a foreign country or a
foreign political party and disclosed under the Foreign Agents
Registration Act of 1938 (22 U.S.C. 611 et seq.);
(v) a request for a meeting, a request for the status of an action, or
any other similar administrative request, if the request does not
include an attempt to influence a covered executive branch official
or a covered legislative branch official;
(vi) made in the course of participation in an advisory committee
subject to the Federal Advisory Committee Act;
(vii) testimony given before a committee, subcommittee, or task
force of the Congress, or submitted for inclusion in the public
record of a hearing conducted by such committee, subcommittee,
or task force;
(viii) information provided in writing in response to an oral or
written request by a covered executive branch official or a covered
legislative branch official for specific information;
(ix) required by subpoena, civil investigative demand, or otherwise
compelled by statute, regulation, or other action of the Congress or
an agency, including any communication compelled by a Federal
contract, grant, loan, permit, or license;
(x) made in response to a notice in the Federal Register, Commerce
Business Daily, or other similar publication soliciting
communications from the public and directed to the agency official
specifically designated in the notice to receive such
communications;
(xi) not possible to report without disclosing information, the
unauthorized disclosure of which is prohibited by law;
(xii) made to an official in an agency with regard to—
         (I) a judicial proceeding or a criminal or civil law
         enforcement inquiry, investigation, or proceeding; or
         (II) a filing or proceeding that the Government is
         specifically required by statute or regulation to maintain or
         conduct on a confidential basis,
         if that agency is charged with responsibility for such
         proceeding, inquiry, investigation, or filing;
(xiii) made in compliance with written agency procedures
regarding an adjudication conducted by the agency under section
554 of title 5 or substantially similar provisions;
(xiv) a written comment filed in the course of a public proceeding
or any other communication that is made on the record in a public
proceeding;
(xv) a petition for agency action made in writing and required to be
a matter of public record pursuant to established agency
procedures;
(xvi) made on behalf of an individual with regard to that
individual‘s benefits, employment, or other personal matters



                                                                   31
                      involving only that individual, except that this clause does not
                      apply to any communication with—
                              (I) a covered executive branch official, or
                              (II) a covered legislative branch official (other than the
                              individual‘s elected Members of Congress or employees
                              who work under such Members‘ direct supervision),
                               with respect to the formulation, modification, or adoption
                              of private legislation for the relief of that individual;
                      (xvii) a disclosure by an individual that is protected under the
                      amendments made by the Whistleblower Protection Act of 1989,
                      under the Inspector General Act of 1978, or under another
                      provision of law;
                      (xviii) made by—
                              (I) a church, its integrated auxiliary, or a convention or
                              association of churches that is exempt from filing a Federal
                              income tax return under paragraph 2(A)(i) of section 6033
                              (a) of title 26, or
                              (II) a religious order that is exempt from filing a Federal
                              income tax return under paragraph (2)(A)(iii) of such
                              section 6033 (a); and
                      (xix) between—
                              (I) officials of a self-regulatory organization (as defined in
                              section 3(a)(26) of the Securities Exchange Act [15 U.S.C.
                              78c (a)(26)]) that is registered with or established by the
                              Securities and Exchange Commission as required by that
                              Act [15 U.S.C. 78a et seq.] or a similar organization that is
                              designated by or registered with the Commodities Future
                              Trading Commission as provided under the Commodity
                              Exchange Act [7 U.S.C. 1 et seq.]; and
                              (II) the Securities and Exchange Commission or the
                              Commodities Future Trading Commission, respectively;
                               relating to the regulatory responsibilities of such
                              organization under that Act.
(9) Lobbying firm
       The term ―lobbying firm‖ means a person or entity that has 1 or more employees
       who are lobbyists on behalf of a client other than that person or entity. The term
       also includes a self-employed individual who is a lobbyist.
(10) Lobbyist
       The term ―lobbyist‖ means any individual who is employed or retained by a client
       for financial or other compensation for services that include more than one
       lobbying contact, other than an individual whose lobbying activities constitute
       less than 20 percent of the time engaged in the services provided by such
       individual to that client over a six month period.
(11) Media organization
       The term ―media organization‖ means a person or entity engaged in disseminating
       information to the general public through a newspaper, magazine, other



                                                                                          32
       publication, radio, television, cable television, or other medium of mass
       communication.
(12) Member of Congress
       The term ―Member of Congress‖ means a Senator or a Representative in, or
       Delegate or Resident Commissioner to, the Congress.
(13) Organization
       The term ―organization‖ means a person or entity other than an individual.
(14) Person or entity
       The term ―person or entity‖ means any individual, corporation, company,
       foundation, association, labor organization, firm, partnership, society, joint stock
       company, group of organizations, or State or local government.
(15) Public official
       The term ―public official‖ means any elected official, appointed official, or
       employee of—
               (A) a Federal, State, or local unit of government in the United States other
               than—
                       (i) a college or university;
                       (ii) a government-sponsored enterprise (as defined in section 622
                       (8) of this title);
                       (iii) a public utility that provides gas, electricity, water, or
                       communications;
                       (iv) a guaranty agency (as defined in section 1085 (j) of title 20),
                       including any affiliate of such an agency; or
                       (v) an agency of any State functioning as a student loan secondary
                       market pursuant to section 1085 (d)(1)(F) of title 20;
               (B) a Government corporation (as defined in section 9101 of title 31);
               (C) an organization of State or local elected or appointed officials other
               than officials of an entity described in clause (i), (ii), (iii), (iv), or (v) of
               subparagraph (A);
               (D) an Indian tribe (as defined in section 450b (e) of title 25; [1]
               (E) a national or State political party or any organizational unit thereof; or
               (F) a national, regional, or local unit of any foreign government, or a
               group of governments acting together as an international organization.
(16) State
The term ―State‖ means each of the several States, the District of Columbia, and any
commonwealth, territory, or possession of the United States.




                                                                                              33
X.     METHODOLOGY

To generate the data reported in Part XII of this report, states health department
employees were surveyed to better understand the following:

1) state public health department employees‘ perceptions of lobbying, advocacy and
public education and their role in all three;

2) the administrative boundaries faced by public health department employees in
educating decision-makers;

3) the role of health department partners in shaping public policy; and

4) public health department success stories when teamed with partners.

The map below illustrates the states of health department employees that participated in
this survey.




                                                                                        KEY
                                                                             Light Blue – 1 respondent

                                                                             Dark Blue – 2 respondents

                                                                             Green – Group Response




BECAUSE SOME STATES HAVE BEEN CREATIVE IN THEIR STRATEGIES IN
ELIMINATING ADMINISTRATIVE BOUNDARIES, MANY REQUESTED
ANONYMITY WHEN EXPLAINING THEIR SUCCESS STORIES. AS SUCH,
STATES WILL BE REFERRED TO GENERICALLY THROUGHOUT THE
DOCUMENT.




                                                                                          34
XII.    TELEPHONE INTERVIEW

In trying to better understand the “legal boundaries” that impact public health workers
in implementing policy and environmental change, it became apparent that the
boundaries were not legal, but administrative. This survey was developed to gather a
comprehensive understanding of the administrative boundaries facing state health
workers and their perception of a state health worker’s role in education, advocacy,
and lobbying. The full text of the survey follows. The responses are not intended to
represent “correct answers”, but are merely a reflection of the perceptions of the public
health department employees who participated in this survey.


I would like to thank you for participating in this survey. We are focusing on boundaries
of state public health agencies in working to support, integrate, and implement health
policy and environmental change interventions that support and improve health. The
objective of this interview is to understand what limitations you and your agency may
face when working with partners, communities and constituents to participate in health
policy and environmental change.
------------------------------------------------------------------------------------------------------------
Section 1
First, I will provide three definitions followed by several scenarios. I would like you to
tell me which definition best describes each scenario.

The first definition is lobbying: 1) to promote or secure the passage of legislation by
influencing public officials; or 2) to attempt to influence a public official toward a desired
action.

The second definition is advocacy: the act of supporting a cause or proposal.

The third and final definition is education: the act of providing information.

Now I would like for you to keep these definitions in mind as I present different
scenarios. Please tell me which definition lobbying, advocacy or education best fits each
scenario. If at any point you need me to re-read the definitions, please let me know.

First scenario:

1) A state employee is asked by a cancer survivor activist and community leader to attend
a local community meeting to speak on Federal funding for cancer programs. During the
meeting the state employee explains what state and local programs are supported by
Federal funding. Is that person:

  Lobbying                   0
  Advocacy                   6%
  Education                  94%



                                                                                                        35
2) During that same community meeting on cancer funding, the state employee hands out
documents that explain how the cancer programs are funded and includes the name and
phone number of the community‘s Representative and Senator. Is that person:

   Lobbying               6%
   Advocacy               37%
   Education              54%
   No Answer              3%

3) If a non-government organization produces literature for public distribution that
includes statistics on state funding levels or state laws on a particular issue, is this:

  Lobbying               0
  Advocacy               14%
  Education              86%


4) If a state employee requests a meeting with their supervisor or director to request more
funding for their program, is this:

  Lobbying               9%
  Advocacy               86%
  Education              3%
  No Answer              3%


5) If a state employee requests a meeting with a state or federal representative to explain
how Federal funding cuts will impact the state program, is this

  Lobbying               11%
  Advocacy               31%
  Education              57%




                                                                                        36
6) If that same state employee asked for a federal funding increase for their programs, is
this
  Lobbying                   51%
  Advocacy                   46%
  Education                  3%


7) An individual or organization establishes a contract with an outside source to provide
Federal government affairs services. The outside organization contacts Members of
Congress to discuss how Federal funds support the client‘s programs within each state.
The outside organization is:

  Lobbying                   26%
  Advocacy                   40%
  Education                  29%
  No Answer                  6%


8) This same outside organization meets with a Member of Congress and specifically
asks for an increase in program funding. The outside organization is:

  Lobbying                   74%
  Advocacy                   26%
  Education                  0

------------------------------------------------------------------------------------------------------------




                                                                                                         37
Section 2

Now I would like you to listen to the following statements and tell me if, in your opinion,
the statement is true or false.

1) All lobbying is advocacy, but in general, not all advocacy is lobbying.

    True or        False
    100%


2) Federal law specifically states that state employees are prohibited from lobbying their
Federal representatives.

    True    or     False
    66%            34%

3) Telephoning my U.S. Senator‘s office on personal time to explain how a funding cut
will impact programs supported in my office is public education.

    True    or     False
    51%            49%


4) A non-governmental organization asks you to prepare a document that shows how
budget cuts have impacted programs within your office. This is public education.


    True    or     False
    89%            11%


5) Participating in an organization‘s Hill Day, but paid for by my office, where I travel to
Washington D.C. to meet with my representatives to explain how my program uses
federal funds is a way for me to educate.


    True    or     False
    27%            49%




                                                                                         38
6) You are participating in lobbying if you provide data to a group that is actively
communicating with a Senator or Representative on behalf of an issue supported by your
office.

  True   or      False
  3%             97%

7) You are educating if a Member of Congress or a State Representative asks you to meet
in their office to discuss a policy issue directed by your office.


  True or        False
  100%


8) You are educating if you call your Senator to inform them how a proposed policy
change will impact your office and the constituents you serve.

  True   or      False
  37%            63%


9) You are attending a meeting on personal time where your U.S. Senator is speaking.
You introduce yourself and explain you are attending because of your concern with how
his proposed policy change will impact your office and the constituents you serve. In this
capacity, you are educating.

  True   or      False
  31%            69%



10) A lobbying organization sends you an e-mail urging you to call your Senator to
support or reject a proposed policy change. If you decide to contact your Senator on
office time this is a form of public education.

  True   or      False
  3%             97%




                                                                                       39
11) State law prohibits me from contacting my state and federal representatives regarding
policy or funding issues affecting my office.

  True     or       False
  43%               57%



12) Office policy prohibits me from contacting my state and federal representative
regarding policy or funding issues affecting my office.

  True     or       False
  65%               29%


------------------------------------------------------------------------------------------------------------
Section 3
Now, I would like to take a few moments to understand your partnerships with local and
national organizations.

1) Do you currently work with a local _______, state _________, or national _________
organization in regards to issues in your office?  Check which ones or No

                                                                        Local             74%
                                                                        State             91%
                                                                        National          89%


If no, proceed to section 4.

If yes:
2) Do you consider that relationship to be a partnership?               Yes      or       No
                                                                        94%               6%



3) Do you and your partner work in a collaborative way to develop initiatives that
enhance the policies of your office?
                                                     Yes or        No
                                                     91%           6%

                                                                        No Answer         3%




                                                                                                         40
4) Do you and your partner work in a collaborative way to develop initiatives that
enhance the funding of your office?
                                                    Yes or       No
                                                    76%          21%


5) Do you develop documents that enhance the mission of your partner?

                                                          Yes     or     No
                                                          74%            24%

                                                          No Answer      3%

If yes, are these documents ever presented to government officials?

                                                          Yes     or     No
                                                          96%            4%


6) Does your partner use documents that you develop for general use?

                                                          Yes     or     No
                                                          97%            3%

7) Do you communicate with your partner when you are concerned about a proposed
policy change?
                                                          Yes     or     No
                                                          85%            12%

                                                          No Answer      3%

If yes, do you work together to produce documents on the impact such change will have
on programs within your office?
                                                        Yes or        No
                                                        79%           21%



8) Does your partner communicate with you their activities as it relates to their lobbying
efforts?

                                                          Yes     or     No
                                                          79%            21%




                                                                                       41
9) Have you ever accompanied your partner to a meeting with a state or Federal
representatives?
                                                                      Yes      or       No
                                                                      56%               41%

                                                                      No Answer         3%

10) Would you accompany your partner to a Congressional meeting to educate the
member and their staff if asked?
                                                 Yes or        No
                                                 74%           21%

                                                                      Depends           6%



------------------------------------------------------------------------------------------------------------


Section 4

Thank you for your answers. I have just one section left where I would like for you to
explain a policy or environmental change program initiative that you participated in
where you felt restricted by administrative policy or current law. I would like to provide
you two examples of the information that we are seeking:

Policy/Environmental Legal Boundary                      Way Around           Success
Change      Initiative                                   Legal Boundary/
(Program)                                                Administrative
                                                         Policy
1st Example: Smoking Lack of funding for                 Partnered with local Yes
Cessation    Initiative the         program;             American Cancer
program                 prohibited        by             Society group who
                        Governor‘s office                asked Congress for
                        to contact Federal               money for initiative
                        representatives for
                        more funding
  nd
2    Example: Local State law prohibits                  Using material from Yes
constituent      wants awards             to             state agency office,
public                  constituents from                constituent works
awards/recognition      state offices                    with      Governor‘s
from state for healthy                                   office           and
behavior changes                                         legislature to amend
                                                         law




                                                                                                         42
1) Can you name a successful locally or state implemented policy or environmental
change initiative in your state that involved your department?

2) What year was the policy or environmental change completed, or is it in progress?

3) What role(s) did the Health Department play in the change?

4) What was the legal or administrative/policy boundary that you faced?

5) How do you overcome that boundary?

6) Was the program successful?        If yes, what were the outcomes?

7) Who were the major external partners involved?

8) Who were the major state/federal officials who publicly supported this effort?

9) Are you tracking the impact and outcomes of this policy or environmental change?

10) What is the most important lesson learned from this policy or environmental change?

________________________________________________________________________


11) Based on your experience, what barriers most often impacted your office and your
attempt to implement healthy policy and environmental change?

12) What is the internal process for you to gain access to policy makers state or federal?

13) Do you think decision-makers have enough relevant information about your
programs to make important policy and funding decisions?

                                                               Yes      or     No
                                                               11%             83%

                                                               Sometimes       3%
                                                               No Answer       3%




                                                                                         43
14) Do you think you could play a more active role in informing decision-makers about
your programs?

                                                              Yes    or      No
                                                              91%            6%

                                                              No Answer      3%


15) Do you think there is a distinction between lobbying, advocacy and public education?
       Yes or No

                                                              Yes    or      No
                                                              94%            6%


      If yes, what are you available for you?
Lobbying __________          Advocacy ___________           Public education ______

16) Finally, what would be helpful to you in understanding how you can better educate
your state and federal representatives about the funding and policy challenges facing your
office? _________________________________________________________________
Thank you for taking time to participate in this survey.




                                                                                       44

								
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