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SPEAK UP YOUR VOICE COUNTS!! Legislative Process Workshop Ken H. Takayama, J.D. Assistant Director for Research Hawaii Legislative Reference Bureau (808)

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Presentation on theme: "SPEAK UP YOUR VOICE COUNTS!! Legislative Process Workshop Ken H. Takayama, J.D. Assistant Director for Research Hawaii Legislative Reference Bureau (808)"— Presentation transcript:

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2 SPEAK UP YOUR VOICE COUNTS!! Legislative Process Workshop Ken H. Takayama, J.D. Assistant Director for Research Hawaii Legislative Reference Bureau (808) 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)

3 Why You Need to be Involved You want to make sure that when your state discusses genetics related legislation, YOU are at the table You want to make sure that when your state discusses genetics related legislation, YOU are at the table

4 Why should you care? Professional licensing Professional licensing Protection from tort liability Protection from tort liability Prohibition of genetics discrimination Prohibition of genetics discrimination  Insurance  Employment  Other Medical Record Confidentiality Medical Record Confidentiality Mandated insurance coverage for genetic counseling services Mandated insurance coverage for genetic counseling services

5 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 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 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 You only make this happen by participating It paves the way when you want to pass your own legislation It paves the way when you want to pass your own legislation

6 How are these things done?

7 All Roads Lead to the Legislature

8 Civics 101: Typical Legislatures (Structure) Consists of two houses: Senate and House of Representatives (sometimes also referred to as the Assembly) Consists of two houses: Senate and House of Representatives (sometimes also referred to as the Assembly) Have members who are elected to represent districts 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) Are organized along partisan lines (i.e. the party having the majority of members controls the operations of that body)

9 Civics 101: Typical Legislatures (Sessions) Meet in session during specified periods 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

10 Civics 101: Typical Legislatures (Committees) Have official meetings in the chambers Have official meetings in the chambers Do most of the real work through various committees Do most of the real work through various committees Work of the committees is directed by their respective chairs Work of the committees is directed by their respective chairs The committees will typically be the forum for your input The committees will typically be the forum for your input

11 Civics 101: Typical Legislatures (Measures) Consider bills as vehicles to enact or change laws or propose constitutional amendments 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 amend a bill (proposal) more than once before passage in that house May require conferencing between members of both houses to iron out differences May require conferencing between members of both houses to iron out differences

12 Civics 101: Lawmaking A bill cannot become law unless both houses agree to enact the same version of that measure 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 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 Any law is always potentially subject to court challenge if people believe it violates higher law or was enacted improperly

13 Civics 101: Lawmaking If it sounds hard to add or change a law If it sounds hard to add or change a law You’re right, it’s supposed to be that way You’re right, it’s supposed to be that way Don’t be discouraged, it can be done Don’t be discouraged, it can be done

14 What Do You Want to Do?

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

16 Can you do it? Think about any barriers or restrictions on your involvement in this process Think about any barriers or restrictions on your involvement in this process  Employer restrictions?  Family or professional restrictions?  Geographical restrictions?

17 Don’t Reinvent the Wheel Possible resources Possible resources  Your colleagues  Professional genetics organizations  Coalition of State Genetics Coordinators    National Conference of State Legislatures (www.ncsl.org)  Statutes from other states

18 Example: Licensure

19 Decide What You Want Practice Protection (Licensing) vs Title Protection (Registration) Practice Protection (Licensing) vs Title Protection (Registration) The Key Difference—practice protection makes it ILLEGAL for someone to practice that profession or vocation unless they are licensed The Key Difference—practice 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 don’t use the TITLE (e.g., “Genetic Counselor”) Title Protection allows people to practice the profession or vocation as long as they don’t use the TITLE (e.g., “Genetic Counselor”)

20 What’s in it for Others? What problems are being caused by a lack of regulation? What problems are being caused by a lack of regulation? If so, what are they? Fly-by-nights? Scam artists? Incompetents? If so, what are they? Fly-by-nights? Scam artists? Incompetents? How do you know? Do you have data? How do you know? Do you have data? Do you REALLY have to have this 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 Hint — It could be useful to have some really great horror stories

21 Address the Nuts and Bolts What standards are required for regulation? What standards are required for regulation? Which agency will oversee the regulation of your profession? 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: It’s more work for them) Have you spoken to the prospective regulators to find out their attitude toward regulating you? (Note: It’s more work for them) Are the agency’s regulatory programs self- financing (i.e., do the licensing/registration fees have to cover the costs)? If so, what are your fees likely to be? Are the agency’s regulatory programs self- financing (i.e., do the licensing/registration fees have to cover the costs)? If so, what are your fees likely to be?

22 Do you still want regulation? The ultimate question: WHAT IS IT WORTH TO YOU?

23 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 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) Health insurers (if they believe it will raise the cost of medical treatment) Prospective regulatory agency whose workload might increase Prospective regulatory agency whose workload might increase

24 Bring in the Outside World

25 Can you do it alone? Barring the most unusual circumstances - not likely or not very effectively Barring the most unusual circumstances - not likely or not very effectively Enlist friends and allies Enlist friends and allies You’ll need to be in agreement. Therefore, YOU may need to COMPROMISE on your concept or proposal You’ll need to be in agreement. Therefore, YOU may need to COMPROMISE on your concept or proposal And you haven’t even dealt with a politician yet!!! And you haven’t even dealt with a politician yet!!!

26 Opponents and Undecided Determine who your likely opponents will be Determine who your likely opponents will be Determine who might be in-between Determine who might be in-between Determine who among them you can swing to your side—or at least neutralize Determine who among them you can swing to your side—or at least neutralize This could mean further COMPROMISE This could mean further COMPROMISE

27 Divide to Conquer Divide duties among your group of advocates 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?

28 How do you decide who does what? Factors that could be relevant: 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!! Remember, some of your best people may help your cause from entirely behind the scenes!!

29 BE PREPARED Do your homework on your state legislative process and the legislators.

30 The Legislative Process For a general overview, materials may be available: For a general overview, materials may be available:  Through your legislature’s library  From individual legislators  Your state’s (or legislature’s) website  Community organizations (e.g. League of Women Voters, local medical association, March of Dimes) who deal with the legislature

31 Information about legislators How do you find out 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

32 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

33 If you don’t have access to these legislators, then…

34 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) 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 don’t know any legislators, then if nothing else, approach your own representative or senator as their constituent If you don’t know any legislators, then if nothing else, approach your own representative or senator as their constituent Whoever you talk to, find out what’s real, what’s possible, and what’s not Whoever you talk to, find out what’s real, what’s possible, and what’s not Using those leads start talking to others Using those leads start talking to others

35 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. 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 As you talk to more people, you may find that you need to modify your proposal in various ways. In other words, more COMPROMISE

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

37 When the Rubber Meets the Road USE YOUR COUNSELING SKILLS

38 Decisions, Decisions Use information gained to: 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

39 Working with the legislator(s) Develop specifications of the proposed legislation 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 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 Get the bill drafted by an appropriate staff agency Review the bill to make sure it meets your needs Review the bill to make sure it meets your needs Make sure you understand the bill Make sure you understand the bill

40 How A Bill Becomes a Law

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

42 Committee Hearings Make sure you know the date and time of the committee hearing for your bill 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) 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) Be prepared to answer questions and criticisms (much like defending a thesis) Use the hearing as an opportunity to educate Use the hearing as an opportunity to educate

43 Post-Committee Hearing Be prepared to work with Committee staff on any proposed amendments to the bill or justify why they shouldn’t amend it Be prepared to work with Committee staff on any proposed amendments to the bill or justify why they shouldn’t amend it Get a copy of the committee report and draft of the bill if changes are made 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 Be prepared to react quickly on the position you will take concerning the bill if changes have been made

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

45 Bicameralism Remember: Unless you’re in Nebraska, the legislature has two houses Remember: Unless you’re in Nebraska, the legislature has two houses Therefore, after you’ve done everything to pass the bill through the first house, you have to do it again in the second Therefore, after you’ve 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 … If the second house makes any changes to the bill that the first house does not agree to, it sets the stage for …

46 Conference Representatives from each house meet to “iron out” the differences in their respective versions of the bill 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) 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 Practically speaking, the conference time is a period of much horse trading and hostage taking

47 After Enactment If the bill is approved by both houses, it is deemed enacted and goes to the governor for approval or veto 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 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 Enlist your supporters to let the governor know about the support for the bill

48 Things to watch out for: Most states have: 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 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 Remember: Notice requirements for hearings and other matters may be very short or non-existent

49 You Can Always Use A Little Help From Your Friends

50 What can you do to keep tabs on what’s going on? Legislative public information services: Legislative public information services:  Public access information numbers  Internet resources  Legislators’ district offices Ideally, have people at the Capitol all the time Ideally, have people at the Capitol all the time Realistically, become friends with staffers at the Capitol who can help you get information Realistically, become friends with staffers at the Capitol who can help you get information

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

52 Working with legislative staff Legislative staff come in many forms: 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 Staff hierarchy tends to reflect the legislative hierarchy

53 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) 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 may need information from you on short notice They can sometimes influence legislators’ decisions if asked to provide input They can sometimes influence legislators’ decisions if asked to provide input Even though they don't have a vote, they can help you Even though they don't have a vote, they can help you Be nice to them Be nice to them

54 So What’s It All About? Lots of things, they include:

55 Knowing who your friends are Which people are your supporters who will vote for your bill 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 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 Who is wavering but still possible to convince

56 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.: 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

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

58 Legislators are people too, albeit busy ones They can be informed about new things They can be informed about new things They are constantly besieged by people who want things from them 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 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 Real people affected with real disorders have a huge impact

59 Legislatures are NOT Monolithic Organisms They are like complex communities of smaller 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

60 Therefore, You do not "work with" or "give information to" THE Legislature 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 the necessary 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 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

61 Remember: WGACA

62 What Goes Around, Comes Around People will probably treat you in the manner that they feel you have treated them 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 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 For better or worse, Legislatures can be the most HUMAN institutions in this society-you encounter the entire range of personalities and behaviors

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


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