SPEAK UP YOUR VOICE COUNTS!! Legislative Process Workshop

1
SPEAK UPYOUR VOICE COUNTS!!Legislative Process
Workshop
National Society of Genetic Counselors Annual
Education Conference November 2000
Sylvia M. Au, M.S., C.G.C. State Genetics
Coordinator Hawaii Department of Health (808)
733-9063

• Ken H. Takayama, J.D.
• Assistant Director for Research
• Hawaii Legislative Reference Bureau
• [phone]

2
Why You Need to be Involved

• You want to make sure that when your state
  discusses genetics related legislation, YOU are
  at the table

3
Why should you care?

• Professional licensing
• Protection from tort liability
• Prohibition of genetics discrimination
• Insurance
• Employment
• Other
• Medical Record Confidentiality
• Mandated insurance coverage for genetic
  counseling services

4
Even if you are not trying to pass any
legislation, you should still care

• It is just as important to kill poorly
  conceived legislation as it is to pass good laws
• It is a good idea to have legislators and
  legislative staff get used to you as an authority
  in genetics
• You only make this happen by participating
• It paves the way when you want to pass your own
  legislation

5
How are these things done?
6
All Roads Lead to the Legislature
7
Civics 101 Typical Legislatures (Structure)

• Consists of two houses Senate and House of
  Representatives (sometimes also referred to as
  the Assembly)
• Have members who are elected to represent
  districts
• Are organized along partisan lines (i.e. the
  party having the majority of members controls the
  operations of that body)

8
Civics 101 Typical Legislatures (Sessions)

• Meet in session during specified periods
• CA, MA, IL, and WI often meet for most of the
  year
• Most legislatures typically are in session for
  about 2-6 months
• Some legislatures (TX, NV, and others) meet only
  every other year

9
Civics 101 Typical Legislatures (Committees)

• Have official meetings in the chambers
• Do most of the real work through various
  committees
• Work of the committees is directed by their
  respective chairs
• The committees will typically be the forum for
  your input

10
Civics 101 Typical Legislatures (Measures)

• Consider bills as vehicles to enact or change
  laws or propose constitutional amendments
• May amend a bill (proposal) more than once before
  passage in that house
• May require conferencing between members of both
  houses to iron out differences

11
Civics 101 Lawmaking

• A bill cannot become law unless both houses agree
  to enact the same version of that measure
• After legislative enactment, the governor may
  still veto the measure thus preventing it from
  becoming a law
• Any law is always potentially subject to court
  challenge if people believe it violates higher
  law or was enacted improperly

12
Civics 101 Lawmaking

• If it sounds hard to add or change a law
• Youre right, its supposed to be that way
• Dont be discouraged, it can be done

13
What Do You Want to Do?
14
How do You do What You Want?

• Decide your issue.
• Enlist colleagues who care about the same issue.
• What do you want to get done?
• Are you sure?
• What are the advantages and disadvantages of your
  proposal?

15
Can you do it?

• Think about any barriers or restrictions on your
  involvement in this process
• Employer restrictions?
• Family or professional restrictions?
• Geographical restrictions?

16
Dont Reinvent the Wheel

• Possible resources
• Your colleagues
• Professional genetics organizations
• Coalition of State Genetics Coordinators
• www.stategeneticscoordinators.org
• National Conference of State Legislatures
  (www.ncsl.org)
• Statutes from other states

17
ExampleLicensure
18
Decide What You Want

• Practice Protection (Licensing) vs Title
  Protection (Registration)
• The Key Differencepractice protection makes it
  ILLEGAL for someone to practice that profession
  or vocation unless they are licensed
• Title Protection allows people to practice the
  profession or vocation as long as they dont use
  the TITLE (e.g., Genetic Counselor)

19
Whats in it for Others?

• What problems are being caused by a lack of
  regulation?
• If so, what are they? Fly-by-nights? Scam
  artists? Incompetents?
• How do you know? Do you have data?
• Do you REALLY have to have this
• information to get regulated? No, but it helps
• Hint It could be useful to have some really
  great horror stories

20
Address the Nuts and Bolts

• What standards are required for regulation?
• Which agency will oversee the regulation of your
  profession?
• Have you spoken to the prospective regulators to
  find out their attitude toward regulating you?
  (Note Its more work for them)
• Are the agencys regulatory programs
  self-financing (i.e., do the licensing/registratio
  n fees have to cover the costs)? If so, what are
  your fees likely to be?

21
Do you still want regulation?

• The ultimate question
• WHAT IS IT WORTH TO YOU?

22
Who might not want licensing?

• For example Because licensing could restrict
  the number of people who work as genetic
  counselors, this may improve salaries for
  licensees.
• Opposition may come from
• Doctors and medical facilities who hire genetic
  counselors as employees
• Nurses and other professions if they believe it
  reduces their scope of work
• Health insurers (if they believe it will raise
  the cost of medical treatment)
• Prospective regulatory agency whose workload
  might increase

23
Bring in the Outside World
24
Can you do it alone?

• Barring the most unusual circumstances - not
  likely or not very effectively
• Enlist friends and allies
• Youll need to be in agreement. Therefore, YOU
  may need to COMPROMISE on your concept or
  proposal
• And you havent even dealt with a politician
  yet!!!

25
Opponents and Undecided

• Determine who your likely opponents will be
• Determine who might be in-between
• Determine who among them you can swing to your
  sideor at least neutralize
• This could mean further COMPROMISE

26
Divide to Conquer

• Divide duties among your group of advocates
• Who will speak to legislators and staff?
• Who will take the lead in testifying?
• Who will serve as the liaison with community
  advocates?
• Who will represent the group with the media?

27
How do you decide whodoes what?

• Factors that could be relevant
• Experience
• Knowledge of subject matter
• Ability to present position clearly and
  succinctly
• Personal connections
• Rapport
• Remember, some of your best people may help your
  cause from entirely behind the scenes!!

28
BE PREPAREDDo your homework on your state
legislative process and the legislators.
29
The Legislative Process

• For a general overview, materials may be
  available
• Through your legislatures library
• From individual legislators
• Your states (or legislatures) website
• Community organizations (e.g. League of Women
  Voters, local medical association, March of
  Dimes) who deal with the legislature

30
Information about legislators

• How do you find out about legislators?
• Read articles about the Legislature and
  legislators
• Check their websites
• Go to hearings to see them in action
• Talk to legislators about themselves
• Talk to people about other people

31
Talking to Legislators

• Factors making certain legislators particularly
  desirable as supporters
• Leadership positions
• Chairs or members of key committees (as they
  relate to your bill)
• Respected or well regarded with respect to
  particular issues
• Strongly agree with your position

32
If you dont have access to these legislators,
then
33
Other Approaches

• Do you or your friends/allies know any
  legislators personally who you think would be
  sympathetic (whether or not they can be
  supportive)
• If you dont know any legislators, then if
  nothing else, approach your own representative or
  senator as their constituent
• Whoever you talk to, find out whats real, whats
  possible, and whats not
• Using those leads start talking to others

34
Keep talking to legislators

• Everyone you speak to can clue you in to other
  legislators or groups who might be helpful or
  opposed. All of this information can be useful.
• As you talk to more people, you may find that you
  need to modify your proposal in various ways. In
  other words, more COMPROMISE

35
Information to Elicitfrom Legislators

• Willingness to take lead in supporting or
  co-sponsoring bill
• Ability/willingness to sponsor bill (e.g. may
  have bill limits)
• Willingness to help or have bill drafted
• Level of emotional support for bill (e.g.
  family member with genetic condition)
• Ability/Resources to help you throughout the
  process

36
When the Rubber Meets the Road

• USE YOUR COUNSELING SKILLS

37
Decisions, Decisions

• Use information gained to
• Choose who you will ask to lead the effort to get
  your bill introduced and passed in each house
• Determine what type of assistance others can
  provide
• Develop strategy to increase base of support

38
Working with the legislator(s)

• Develop specifications of the proposed
  legislation
• Use this opportunity to clarify that you and your
  sponsor legislator(s) agree on the specifics of
  the proposal
• Get the bill drafted by an appropriate staff
  agency
• Review the bill to make sure it meets your needs
• Make sure you understand the bill

39
How A Bill Becomes a Law
40
The Session

• Bill gets introduced into the first house and
  referred to one or more committees
• Work with supporters to have bill scheduled for a
  hearing in every committee
• Typically, most bills die in committee
• Remember to search for other genetics related
  bills which have been introduced

41
Committee Hearings

• Make sure you know the date and time of the
  committee hearing for your bill
• Make sure to show up in person to give testimony
  or at least submit written testimony (Note make
  sure you include your contact information)
• Be prepared to answer questions and criticisms
  (much like defending a thesis)
• Use the hearing as an opportunity to educate

42
Post-Committee Hearing

• Be prepared to work with Committee staff on any
  proposed amendments to the bill or justify why
  they shouldnt amend it
• Get a copy of the committee report and draft of
  the bill if changes are made
• Be prepared to react quickly on the position you
  will take concerning the bill if changes have
  been made

43
Repeat Process Over and Over Again for Every
Committee to which the Bill is Referred
44
Bicameralism

• Remember Unless youre in Nebraska, the
  legislature has two houses
• Therefore, after youve done everything to pass
  the bill through the first house, you have to do
  it again in the second
• If the second house makes any changes to
  the bill that the first house does not agree to,
  it sets the stage for

45
Conference

• Representatives from each house meet to iron
  out the differences in their respective versions
  of the bill
• Although hearings are not typically held, you may
  be able to work with conferees on both sides
  (e.g. by supplying appropriate language to be
  added or changed)
• Practically speaking, the conference time is a
  period of much horse trading and hostage taking

46
After Enactment

• If the bill is approved by both houses, it is
  deemed enacted and goes to the governor for
  approval or veto
• The governor may veto a bill for any reason or no
  reason at all, and sometimes may do just that
• Enlist your supporters to let the governor know
  about the support for the bill

47
Things to watch out for

• Most states have
• A deadline by which all bills must be introduced
• A deadline by which bills must be passed out of
  the first house and sent to the second
• Learn as much as you can about specific procedure
  requirements in your state
• Remember Notice requirements for hearings and
  other matters may be very short or non-existent

48
You Can Always Use

• A Little Help From Your Friends

49
What can you do to keep tabs on whats going on?

• Legislative public information services
• Public access information numbers
• Internet resources
• Legislators district offices
• Ideally, have people at the Capitol all the time
• Realistically, become friends with staffers at
  the Capitol who can help you get information

50
What can Legislators/staff do besides vote for
your bill?

• Plenty
• Help you keep track of measures
• Let you know about upcoming hearings
• General "intelligence
• What people are saying/thinking/doing about/to
  your bill
• Who it might be helpful/necessary to talk to
• What kind of information you need to supply and
  to whom

51
Working with legislative staff

• Legislative staff come in many forms
• Personal staff to individual legislators
• Staff assigned to legislative committees
• Staff assigned to legislative leadership
• Partisan and non-partisan staff offices who do
  not work specifically for individual legislators
• Staff hierarchy tends to reflect the legislative
  hierarchy

52
Working with Legislative Staff

• The staff usually need to translate the
  decisions/intent of the legislators into
  documents or products (e.g., amended versions of
  bills,committee reports)
• They may need information from you on short
  notice
• They can sometimes influence legislators
  decisions if asked to provide input
• Even though they don't have a vote, they can help
  you
• Be nice to them

53
So Whats It All About?

• Lots of things, they include

54
Knowing who your friends are

• Which people are your supporters who will vote
  for your bill
• Who are truly your champions who will not only
  vote for your bill but will actively promote your
  cause
• Who is wavering but still possible to convince

55
Knowing who your friends may be

• Who (if any) might "have to" oppose your bill if
  forced to vote on it, but who could help in other
  ways, e.g.
• Voting your way on a procedural motion that
  doesn't reflect the substance of the bill
• Willing to "take a walk" so as not to be in the
  room when the vote on your bill comes up

56
Educating people

• To be successful and effective, be ready to
  educate, educate, educate
• This is what lobbyists do best
• Who Anyone who will listen
• When Constantly
• What Anything that promotes your goal

57
Legislators are people too, albeit busy ones

• They can be informed about new things
• They are constantly besieged by people who want
  things from them
• They hear a great deal from bureaucrats and
  professional lobbyists. It can be a refreshing
  change to hear from real people like you
• Real people affected with real disorders have a
  huge impact

58
Legislatures are NOT Monolithic Organisms

• They are like complex communities of smaller
  organisms.
• A number of those organisms work together
• Others work against each other on many occasions
• Some may not even speak to each other
• The "lineup" of who falls into which of the
  foregoing categories can change over time
  -sometimes from one day to the next

59
Therefore,

• You do not "work with" or "give information to"
  THE Legislature
• You may do each with a group here and there
• But be ready to work with or give information to
  each house, each committee in each house, and if
  necessary, each legislator on each of
  thenecessary committees - not to mention others
  -one at a time, all day, every day
• Like selling cookies door-to-door, you don't sell
  them to "the neighborhood"- you sell them to each
  family, one house at a time

60
Remember

• WGACA

61
What Goes Around, Comes Around

• People will probably treat you in the manner that
  they feel you have treated them
• If you believe the adage that "The Customer Is
  Always Right", a Legislature is an excellent
  forum in which to practice this - constantly
• For better or worse, Legislatures can be the most
  HUMAN institutions in this society-you encounter
  the entire range of personalities and behaviors

62
Think of your involvement in the legislative
process as the best test of the professional
skills you have acquired and developed as genetic
counselors