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How Does a Lobbyist Add Value to Dietetics Advocacy?
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PUBLIC POLICY NEWS
How Does a Lobbyist Add Value to Dietetics Advocacy?
S
enator Paul Wellstone, who died tragically in a plane crash 4 years ago, said all politics are personal. Tip O’Neill, former Speaker of the House for many years, said all politics are local. Both are correct for registered dietitians (RDs). As affiliates work through strategic plans and focus on public policy agendas that truly advance dietetics and public health, the option to hire a lobbyist is most frequently the chosen path. Guiding lawmakers toward effective solutions requires state associations to be informed and prepared to lead RDs toward the issues that matter in their state legislatures. The need for a lobbyist has been to focus on legislative and regulatory issues affecting the public health and dietetics. The push for state licensure for RDs was the catalyst for affiliates’ first serious advocacy campaigns. Our affiliates were hiring lobbyists to help craft legislation and negotiate the legislative processes in ways that would bring dietetics in line with other licensed health care professions. Across the country partnerships were formed as licensure committees advised their lobbyists what needed to be in this legislation, and lobbyists worked behind the scenes advising the affiliates of champions for licensure as well as potential opponents. Together, they charted the path the volunteer leaders would take in the halls of state capitals, and together their contributions helped make dietetics licensure a reality. Once licensure was achieved, many affiliates continued to rely on profesThis article was written by Mary Pat Raimondi, MS, RD, chair of ADA’s Legislative and Public Policy Committee and Juliana Smith, MEd, director of State Government Relations in ADA’s Washington, DC office. doi: 10.1016/j.jada.2006.11.024
30
sional lobbyists. A survey completed in 2005 found that 38 affiliates hired lobbyists. Sixty-one percent of those lobbyists worked for their affiliate for at least 5 years. Those statistics give insights to the roles and relationships that affiliates often have with the people they hire to help them in state capitals. More than half of incoming affiliate presidents take office on June 1 each year and are tasked with managing and working with a professional whose expertise they often do not understand. And in the majority of those cases, the new president is “inheriting” a lobbyist who has been on the scene for a while. To add to the challenge, the sequence of ADA’s June–May year doesn’t mesh with the lobbyist’s and the state’s January–December legislative calendar. The situation demands that the incoming president and the affiliate Board of Directors get on top of the situation from the outset by establishing their public policy agenda, planning the program of work, and then reviewing the status of their affiliate/lobbyist relationship. Points to consider in this process: ●
●
●
●
●
Journal of the AMERICAN DIETETIC ASSOCIATION
Is there a need for the lobbyist considering the coming year’s public policy agenda? If dietetics licensure is law in the state, is there a need to maintain a full-time contract with the lobbyist? Would a contract with fewer client hours serve the affiliate’s need for information and guidance? What are the legislative and regulatory needs of the affiliate? Are there issues on the horizon that will require political strength and awareness of opposition to the profession? What is the affiliate’s “comfort zone” with public policy issues? What collective public policy experience is a part of the affiliate leadership? (This helps to determine the need for a lobbyist.) What are the qualities/skill sets needed in your lobbyist?
●
●
●
●
●
What evaluation process is in place and what is clear on accountability? (Often the president finds that there is no accountability in place and the affiliate Board of Directors must begin that process.) How do you plan to communicate with your lobbyist? How often? And will there be face-to-face meetings throughout the year? What is the affiliate budget allowance for a lobbyist? (Considerations should include other budget items such as the annual meeting.) What are your geographic needs? (The size of the state and your state legislature makes a difference in the demand for a lobbyist.) What are the responsibilities of both the state affiliate leaders and the lobbyist? Who will do what task and how will the outcomes be communicated?
LOBBYING BEYOND LICENSURE ADA’s experience in working with affiliates shows that there are instances when a good lobbyist is key to the affiliate’s successes in their state capitals. Surely that is true on “bread and butter” issues like licensure and practice acts. However, when the issue is the greater good, how does the lobbyist add value? California found extraordinary value working on both professional practice issues and scores of public health measures. According to Sally Cohenour, MS, RD, former California Dietetic Association (CDA) legislative liaison, “The California Dietetic Association promotes optimal nutrition and health for Californians by advocating on two fronts: 1) professional practice of the RD and 2) protection of the public and lifelong health promotion and disease prevention. On the professional practice front, we took a different approach and added to our 1982 Title Act, in a stepwise fashion, making it quite comprehensive. Ac-
© 2007 by the American Dietetic Association
PUBLIC POLICY NEWS Five Tips for Hiring a Lobbyist 1. Consider scripted interview questions to specifically focus on skills, experience, and reputation in state legislatures, especially looking for a proactive lobbyist. 2. Agree on a contract, specifying the terms of the agreement. 3. Set up a system for evaluation and accountability reporting, making expectations clear. 4. Review your affiliate budget to determine affordability and decide on the financial hiring terms— on retainer, annual contract, etc. 5. Make sure your candidate for lobbyist is the kind of lobbyist who really understands how to assist the affiliate in promoting your profession—through state contacts and other ways to enhance affiliate visibility.
tions by our members to support public health improvements allowed RDs to become known to our individual legislators as nutrition leaders; as such, we offered our expertise to the legislator. That helped us be viewed as having a larger interest beyond our own professional practice,” she said. “The team approach with our lobbyist and our licensure committee has been effective. Our lobbyist’s role has been essential; it is set by the CDA Executive Board, and then directed by the vice president of Public Policy. The lobbyist always screens and identifies proposed legislation and advises CDA on strategy and actions. When directed, he has also drafted amendments or entire bills, educated our membership at meetings, and advocated directly on our behalf in obtaining access for key meetings and assisting in passing/defeating key bills. CDA uses a team effort involving the lobbyist and the CDA Executive Board/Public Policy Council,
Three Important Priorities in Working with Lobbyists at the State Level 1. Legislation. 2. Regulation. 3. Developing important state contacts.
with the members providing grassroots lobbying efforts. Together we have made a difference in California.” It is not so clear, though, that lobbyists should be retained for public health advocacy unless there is a specific RD provision in a proposal. One important consideration is your budget and resource analysis. The lobbyist’s salary can be a big part of the budget that now competes with other things like training, technology, and travel. Affiliates need to question what level of representation is needed. There may be a need to be
Become Change Leaders for the Profession! Implement the Nutrition Care Process “As an RD, the nutrition care process allows me to focus on patient outcomes, which improves the overall health of my patients.”
Achieve better patient outcomes and comply with JCAHO standards. Adopt the Nutrition Care Process: ■ Nutrition assessment ■ Nutrition diagnosis ■ Nutrition intervention ■ Nutrition monitoring and evaluation Enhance your value to the health care team.
To learn more about the Nutrition Care Process, visit www.eatright.org/ncp.
January 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION
31
PUBLIC POLICY NEWS Who’s On First? Knowing who takes the lead in state advocacy helps keep the work flowing smoothly and returns the benefits to everyone involved. Here are suggestions for appropriate responsibilities. The Member Leader 1. Taking charge of your legislative day and/or legislative receptions. 2. Making introductory contact through meetings with your state legislators. 3. Being the expert witness at hearings. The Lobbyist 1. Finding a bill sponsor for “bread and butter” affiliate issues. 2. Drafting bill language. 3. Meeting with the opposition and state legislators. Not everything is cut and dried in advocacy work and not every issue demands hiring a full-time lobbyist. Here are three creative ideas for holding down costs while advancing the profession and better nutrition and health: 1. Affiliates could work with a local college or university dietetics classes to monitor nutrition issues in play in the state. 2. Affiliate public policy committee member leaders could be assigned to track specific legislation and regulations. 3. Find ways to motivate more affiliate members to be involved through grassroots outreach. Train them to be good at representing their own and affiliate interests. (ADA’s State Government Relations can help!)
creative to maximize the value of dollars paid to professional lobbyists with the contributions of volunteer advocacy. That has proven a winning combination in state after state. When retaining a lobbyist it is important to contract for both legislative and regulatory issues, as well as to help the RD advance the profession
32
January 2007 Volume 107 Number 1
through increased visibility with state contacts. If your affiliate is hiring a lobbyist there are a number of things to consider. Once your lobbyist is on board, there are several focus challenges. It is beneficial to consider a lobbyist who understands the value in working closely with your national association. In this way, the lobbyist can help your state legislature understand the professional national association behind the affiliate. One of the greatest benefits of hiring a lobbyist is to help the affiliate gain recognition through increased state contacts and generally promote the professionalism of the RD. When Tennessee Dietetic Association (TDA) hired Nan Allison MS, RD, as their lobbyist, they learned the value of increased visibility for their affiliate. After 10 years in that position and also serving as TDA executive director, Allison learned from a different perspective the role of the lobbyist. “It is important for the lobbyist to not only focus on one bill, but be available during the legislative session to act as a resource on related issues. When the lobbyist is an active player in legislative activities, the legislators begin to rely on you as a resource and an RD to answer questions on issues as they arise. Your influence increases exponentially and begins to enhance the profession.” “My advice is to ask the lobbyist in the interview process if he or she plans to be active throughout the session. Does he or she plan to be in the capital hallways where 80% of the political business is handled?” said Allison. “In the role of an RD and as an executive director for the affiliate, I was in a position to be a part of public policy meetings that impacted the legislative agenda of the lobbying initiatives. I was able to recognize when the substance of the issue demanded that we make sure that nutrition components were included at the appropriate juncture.” Keeping the RD in the forefront is an important piece of the strategy. You want your state contacts to learn more about your affiliate as a resource, and to build that important relationship directly with you as member leaders. Keeping leadership skills current is important for member leaders as well as remaining very active in strategy planning and meet-
ings. The lobbyist should know when and where to take the lead. One instance where a lobbyist did take the lead at an important crossroads was in South Carolina as they worked to get licensure last summer. Donna Quirk, RD, the licensure chair for South Carolina, said, “Our lobbyist was an important factor in our success this year in getting licensure. Two key points that come to mind are: a strong track record with other health care initiatives and relationships. Our lobbyist had strong ties with all of the key players in both the legislative branch and the executive branch. Putting his experience into action for us, he was determined not to let the opposition win. He reached out to our opposition and insisted that they sit at the table with him and sort out their differences. Our lobbyist led the way in developing a joint position to present to the legislature. This skill in working through those issues with our opposition, made the difference for our legislature finally passing licensure. The strength of the professionalism and the relationships we developed with out lobbyist took us to victory with the legislature’s overriding the governor’s veto of our bill.” As the lobbyist follows the path for the year’s work, he or she has to communicate regularly with the affiliate leaders. This can be done by reporting to the affiliate at specified intervals. Because the contract is with the affiliate, the lobbyist isn’t accountable to just one or two contacts, but rather, accountable to the affiliate’s Board of Directors for meeting contract terms and achieving outcomes. Regardless of how strong a proactive lobbyist may be, the affiliate leaders must continue to use that personal touch themselves by reaching out to key state contacts. In the end, the responsibility for advancing the profession and developing a proactive public policy agenda in the state lies within the affiliate membership. Our affiliate members can be strong leaders as they are reminded that “all politics are local.”
PUBLIC POLICY NEWS
How Does a Lobbyist Add Value to Dietetics Advocacy?
S
enator Paul Wellstone, who died tragically in a plane crash 4 years ago, said all politics are personal. Tip O’Neill, former Speaker of the House for many years, said all politics are local. Both are correct for registered dietitians (RDs). As affiliates work through strategic plans and focus on public policy agendas that truly advance dietetics and public health, the option to hire a lobbyist is most frequently the chosen path. Guiding lawmakers toward effective solutions requires state associations to be informed and prepared to lead RDs toward the issues that matter in their state legislatures. The need for a lobbyist has been to focus on legislative and regulatory issues affecting the public health and dietetics. The push for state licensure for RDs was the catalyst for affiliates’ first serious advocacy campaigns. Our affiliates were hiring lobbyists to help craft legislation and negotiate the legislative processes in ways that would bring dietetics in line with other licensed health care professions. Across the country partnerships were formed as licensure committees advised their lobbyists what needed to be in this legislation, and lobbyists worked behind the scenes advising the affiliates of champions for licensure as well as potential opponents. Together, they charted the path the volunteer leaders would take in the halls of state capitals, and together their contributions helped make dietetics licensure a reality. Once licensure was achieved, many affiliates continued to rely on profesThis article was written by Mary Pat Raimondi, MS, RD, chair of ADA’s Legislative and Public Policy Committee and Juliana Smith, MEd, director of State Government Relations in ADA’s Washington, DC office. doi: 10.1016/j.jada.2006.11.024
30
sional lobbyists. A survey completed in 2005 found that 38 affiliates hired lobbyists. Sixty-one percent of those lobbyists worked for their affiliate for at least 5 years. Those statistics give insights to the roles and relationships that affiliates often have with the people they hire to help them in state capitals. More than half of incoming affiliate presidents take office on June 1 each year and are tasked with managing and working with a professional whose expertise they often do not understand. And in the majority of those cases, the new president is “inheriting” a lobbyist who has been on the scene for a while. To add to the challenge, the sequence of ADA’s June–May year doesn’t mesh with the lobbyist’s and the state’s January–December legislative calendar. The situation demands that the incoming president and the affiliate Board of Directors get on top of the situation from the outset by establishing their public policy agenda, planning the program of work, and then reviewing the status of their affiliate/lobbyist relationship. Points to consider in this process: ●
●
●
●
●
Journal of the AMERICAN DIETETIC ASSOCIATION
Is there a need for the lobbyist considering the coming year’s public policy agenda? If dietetics licensure is law in the state, is there a need to maintain a full-time contract with the lobbyist? Would a contract with fewer client hours serve the affiliate’s need for information and guidance? What are the legislative and regulatory needs of the affiliate? Are there issues on the horizon that will require political strength and awareness of opposition to the profession? What is the affiliate’s “comfort zone” with public policy issues? What collective public policy experience is a part of the affiliate leadership? (This helps to determine the need for a lobbyist.) What are the qualities/skill sets needed in your lobbyist?
●
●
●
●
●
What evaluation process is in place and what is clear on accountability? (Often the president finds that there is no accountability in place and the affiliate Board of Directors must begin that process.) How do you plan to communicate with your lobbyist? How often? And will there be face-to-face meetings throughout the year? What is the affiliate budget allowance for a lobbyist? (Considerations should include other budget items such as the annual meeting.) What are your geographic needs? (The size of the state and your state legislature makes a difference in the demand for a lobbyist.) What are the responsibilities of both the state affiliate leaders and the lobbyist? Who will do what task and how will the outcomes be communicated?
LOBBYING BEYOND LICENSURE ADA’s experience in working with affiliates shows that there are instances when a good lobbyist is key to the affiliate’s successes in their state capitals. Surely that is true on “bread and butter” issues like licensure and practice acts. However, when the issue is the greater good, how does the lobbyist add value? California found extraordinary value working on both professional practice issues and scores of public health measures. According to Sally Cohenour, MS, RD, former California Dietetic Association (CDA) legislative liaison, “The California Dietetic Association promotes optimal nutrition and health for Californians by advocating on two fronts: 1) professional practice of the RD and 2) protection of the public and lifelong health promotion and disease prevention. On the professional practice front, we took a different approach and added to our 1982 Title Act, in a stepwise fashion, making it quite comprehensive. Ac-
© 2007 by the American Dietetic Association
PUBLIC POLICY NEWS Five Tips for Hiring a Lobbyist 1. Consider scripted interview questions to specifically focus on skills, experience, and reputation in state legislatures, especially looking for a proactive lobbyist. 2. Agree on a contract, specifying the terms of the agreement. 3. Set up a system for evaluation and accountability reporting, making expectations clear. 4. Review your affiliate budget to determine affordability and decide on the financial hiring terms— on retainer, annual contract, etc. 5. Make sure your candidate for lobbyist is the kind of lobbyist who really understands how to assist the affiliate in promoting your profession—through state contacts and other ways to enhance affiliate visibility.
tions by our members to support public health improvements allowed RDs to become known to our individual legislators as nutrition leaders; as such, we offered our expertise to the legislator. That helped us be viewed as having a larger interest beyond our own professional practice,” she said. “The team approach with our lobbyist and our licensure committee has been effective. Our lobbyist’s role has been essential; it is set by the CDA Executive Board, and then directed by the vice president of Public Policy. The lobbyist always screens and identifies proposed legislation and advises CDA on strategy and actions. When directed, he has also drafted amendments or entire bills, educated our membership at meetings, and advocated directly on our behalf in obtaining access for key meetings and assisting in passing/defeating key bills. CDA uses a team effort involving the lobbyist and the CDA Executive Board/Public Policy Council,
Three Important Priorities in Working with Lobbyists at the State Level 1. Legislation. 2. Regulation. 3. Developing important state contacts.
with the members providing grassroots lobbying efforts. Together we have made a difference in California.” It is not so clear, though, that lobbyists should be retained for public health advocacy unless there is a specific RD provision in a proposal. One important consideration is your budget and resource analysis. The lobbyist’s salary can be a big part of the budget that now competes with other things like training, technology, and travel. Affiliates need to question what level of representation is needed. There may be a need to be
Become Change Leaders for the Profession! Implement the Nutrition Care Process “As an RD, the nutrition care process allows me to focus on patient outcomes, which improves the overall health of my patients.”
Achieve better patient outcomes and comply with JCAHO standards. Adopt the Nutrition Care Process: ■ Nutrition assessment ■ Nutrition diagnosis ■ Nutrition intervention ■ Nutrition monitoring and evaluation Enhance your value to the health care team.
To learn more about the Nutrition Care Process, visit www.eatright.org/ncp.
January 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION
31
PUBLIC POLICY NEWS Who’s On First? Knowing who takes the lead in state advocacy helps keep the work flowing smoothly and returns the benefits to everyone involved. Here are suggestions for appropriate responsibilities. The Member Leader 1. Taking charge of your legislative day and/or legislative receptions. 2. Making introductory contact through meetings with your state legislators. 3. Being the expert witness at hearings. The Lobbyist 1. Finding a bill sponsor for “bread and butter” affiliate issues. 2. Drafting bill language. 3. Meeting with the opposition and state legislators. Not everything is cut and dried in advocacy work and not every issue demands hiring a full-time lobbyist. Here are three creative ideas for holding down costs while advancing the profession and better nutrition and health: 1. Affiliates could work with a local college or university dietetics classes to monitor nutrition issues in play in the state. 2. Affiliate public policy committee member leaders could be assigned to track specific legislation and regulations. 3. Find ways to motivate more affiliate members to be involved through grassroots outreach. Train them to be good at representing their own and affiliate interests. (ADA’s State Government Relations can help!)
creative to maximize the value of dollars paid to professional lobbyists with the contributions of volunteer advocacy. That has proven a winning combination in state after state. When retaining a lobbyist it is important to contract for both legislative and regulatory issues, as well as to help the RD advance the profession
32
January 2007 Volume 107 Number 1
through increased visibility with state contacts. If your affiliate is hiring a lobbyist there are a number of things to consider. Once your lobbyist is on board, there are several focus challenges. It is beneficial to consider a lobbyist who understands the value in working closely with your national association. In this way, the lobbyist can help your state legislature understand the professional national association behind the affiliate. One of the greatest benefits of hiring a lobbyist is to help the affiliate gain recognition through increased state contacts and generally promote the professionalism of the RD. When Tennessee Dietetic Association (TDA) hired Nan Allison MS, RD, as their lobbyist, they learned the value of increased visibility for their affiliate. After 10 years in that position and also serving as TDA executive director, Allison learned from a different perspective the role of the lobbyist. “It is important for the lobbyist to not only focus on one bill, but be available during the legislative session to act as a resource on related issues. When the lobbyist is an active player in legislative activities, the legislators begin to rely on you as a resource and an RD to answer questions on issues as they arise. Your influence increases exponentially and begins to enhance the profession.” “My advice is to ask the lobbyist in the interview process if he or she plans to be active throughout the session. Does he or she plan to be in the capital hallways where 80% of the political business is handled?” said Allison. “In the role of an RD and as an executive director for the affiliate, I was in a position to be a part of public policy meetings that impacted the legislative agenda of the lobbying initiatives. I was able to recognize when the substance of the issue demanded that we make sure that nutrition components were included at the appropriate juncture.” Keeping the RD in the forefront is an important piece of the strategy. You want your state contacts to learn more about your affiliate as a resource, and to build that important relationship directly with you as member leaders. Keeping leadership skills current is important for member leaders as well as remaining very active in strategy planning and meet-
ings. The lobbyist should know when and where to take the lead. One instance where a lobbyist did take the lead at an important crossroads was in South Carolina as they worked to get licensure last summer. Donna Quirk, RD, the licensure chair for South Carolina, said, “Our lobbyist was an important factor in our success this year in getting licensure. Two key points that come to mind are: a strong track record with other health care initiatives and relationships. Our lobbyist had strong ties with all of the key players in both the legislative branch and the executive branch. Putting his experience into action for us, he was determined not to let the opposition win. He reached out to our opposition and insisted that they sit at the table with him and sort out their differences. Our lobbyist led the way in developing a joint position to present to the legislature. This skill in working through those issues with our opposition, made the difference for our legislature finally passing licensure. The strength of the professionalism and the relationships we developed with out lobbyist took us to victory with the legislature’s overriding the governor’s veto of our bill.” As the lobbyist follows the path for the year’s work, he or she has to communicate regularly with the affiliate leaders. This can be done by reporting to the affiliate at specified intervals. Because the contract is with the affiliate, the lobbyist isn’t accountable to just one or two contacts, but rather, accountable to the affiliate’s Board of Directors for meeting contract terms and achieving outcomes. Regardless of how strong a proactive lobbyist may be, the affiliate leaders must continue to use that personal touch themselves by reaching out to key state contacts. In the end, the responsibility for advancing the profession and developing a proactive public policy agenda in the state lies within the affiliate membership. Our affiliate members can be strong leaders as they are reminded that “all politics are local.”