It may be difficult for your chapter and its government relations committee to monitor legislative activity quickly or accurately enough to affect an issue's outcome. In addition, once a chapter has addressed an issue, it may not have the needed expertise to guide the legislation through the political process. First, the chapter should have a legislative committee, or, at least, a designated member who is responsible for legislative issues. To best fulfill both the legislative functions of monitoring and lobbying, the ACRA recommends that chapters consider hiring a lobbyist or lobbying firm.
The advantages of hiring a lobbyist or lobbying firm are many. For instance, lobbyists:
- Are professionals in their field, providing expertise in legislative strategy and technique to facilitate legislation through the process
- Can quickly respond to issues and can assist chapters in providing appropriate communication to key legislators and regulators
- Can identify where leverage needs to be applied and can point out pitfalls, because understand the political climate in the state
- Can monitor the legislative process in an efficient and accurate manner
- Understand how legislation is formulated and can analyze and draft persuasive legislative language
- Allow your chapter to devote its time where it may best be used, in providing technical advice and direction in policy
There are, however, some disadvantages to having a lobbyist. First is the expense. While fees will vary depending on the service agreement, generally fees will be similar to those charged by law firms. Thus, the chapter needs to negotiate fees in advance. Issuing a request for proposal (RFP) may ensure that your chapter gets a lobbyist or lobbying firm within budget and that the expectations of both parties are clear.
It is nearly impossible to measure the benefit side of hiring a lobbyist. Not only is most legislation not quantifiable, the lobbyist often works to defeat legislation counter to the interests of the chapter as much as he works to pass chapter-endorsed legislation. There are other tasks that a good lobbyist may perform that may have benefits well into the future. For instance, a lobbyist who engages the chapter in developing good relations with legislators may pay off well into the future as these relations continue to develop. In addition to the traditional role a lobbyist plays in dealing with legislative research and bill monitoring, he or she can also assist a chapter by working on regulatory issues and representing the chapter as its liaison with state regulatory agencies. While money is a critical factor in hiring a lobbyist, a chapter should not overlook the full value a lobbyist can provide.
Lobbyists are not doctors and may not immediately understand or appreciate the problems faced by physicians today. Some state chapters that currently have lobbyists can attest that they are much busier now than before they hired the lobbyist. Thus, hiring a lobbyist does not absolve the chapter and its leadership from the responsibility to be involved in the legislative process. Chapters must educate their lobbyists on substantive professional issues that matter to the field of radiology.
Choosing a lobbyist for your chapter requires considerable effort. While no list is complete, here are a few things you should consider.
- Identify your need for a lobbyist. If your chapter is in a state with or without a strong industry advocacy presence; if it is in a trend-setting state; or if it is presented with specific legislative challenges or opportunities that go beyond the time and resources of your government relations committee, then you likely should consider hiring a lobbyist. The chapter should not rely solely on the state's medical association to always represent the best legislative interests of radiology and the chapter's members. Also, your chapter should be realistic in identifying its direction and activism on legislative efforts. It might be sufficient for your chapter to hire a lobbyist or law firm to only monitor bills, but not lobby actively on your behalf.
- Understand the impact on tax status. Your chapter should understand its tax status and the impact certain lobbying activities can have on such status. If a chapter is categorized as a 501(c)(3) not-for-profit organization, it will have legal limits on the amount of expenditures it can make related to lobbying or "advocacy" activities. Chapters categorized as a 501(c)(6) organization do not have limitations on the amount of expenditures it can make towards lobbying efforts. For more detailed information about chapter tax status and implications, please see the "Choice of 501(c)(3) vs. 501(c)(6) Organizational Status" in the Government Relations Chapter Handbook.
- Find available lobbyists. The process of finding a lobbyist can be a relatively easy one. One way is to obtain and review the state's register of lobbyists—usually located at the State Legislature offices. Additionally, your chapter could contact political or business leaders. Consider calling the office of the Speaker of the House of Representatives or the President of the Senate for possible recommendations.
- Know the lobbyist's clientele. It is fundamentally important to know the other clients of the lobbying firm. Some physicians' organizations have hired lobbyists who have represented interests such as the hospital association, the tobacco growers, and the insurance industry. While some states have conflict-of-interest laws that prohibit such arrangements, some firms may not fully disclose those relationships. Ask to see a list of clients—not only those represented by your lobbyist, but also the client list for the entire firm. It is important to remember that a chapter may have conflicts with other groups on certain issues. A lobbyist that represents other physician organizations may not always be the best choice.
Find out who will be assigned specifically to work with your chapter. You may have selected your lobbyist on the basis of interviews or word of mouth or on the basis of that lobbyist's political acumen and reputation. Then you find out just a month into the contract that your lobbyist is working on another client's matters, and your issue has been sent to an associate. While some firms will allow you to only "hire the firm," you have a right to know who your representative will be and should feel comfortable with that individual before signing the contract.
- Conduct interviews. Never hire a firm by word of mouth alone; check them out through an interview. You would never hire an employee without an interview. The same principle applies to hiring a lobbyist. Ask about background, communication style, and work in the health care area. Most importantly, find out what contacts the firm has had with legislators and staff who have jurisdiction over your issues, as well as contacts they have in the Governor's Office.
- Ask for references. If members of the chapter have close relationships with elected officials, check out the lobbyist with those politicians or critical staff persons. Let them know that you have a list of lobbyists that you are considering and that you value their opinion. Even if you do not select that lobbyist, it is likely that the officials will appreciate you coming to them. Otherwise you risk selecting someone who may alienate the legislators and their staffs. Ask some of the lobbyists of proponents or opponents of a recently decided issue how the lobbyist's firm added or detracted from the issue's outcome, where appropriate. Ask the state medical association for its reaction to the individual or firm. Is this person someone they can work with?
- Look at more than one lobbyist. Ask for several recommendations (at least three) from political or business leaders for lobbyists. Consider calling the office of the Speaker of the House of Representatives or the President of the Senate for recommendations. Check all the options available, negotiate the price, and then compare, so that you retain the best lobbyist(s) within your price range. Do not settle for a lobbyist you do not feel comfortable with. Also, it is important that you determine the terms of the contract in both the scope of work to be performed and for the duration.
You have hired a lobbyist for the chapter, now what? Make certain you familiarize the lobbyist not just with your chapter's issues, but also with the chapter as a whole. Encourage the lobbyist to visit local hospitals and radiology centers, give the lobbyist background information about your chapter, and be sure to include the lobbyist in meetings with the government relations committee. Also, the lobbyist should regularly attend chapter meetings to provide a report on his or her activities. Further, give your members an opportunity to get to know the lobbyist by providing time for the members to ask the lobbyist questions.
Of course, agreeing with the lobbyist on retainer or contract costs is very important. Most state legislatures work on a part-time basis, so the chapter should consider structuring its contract with the lobbyist based on the days or months a legislature is in session instead of a yearly contract. In addition, the chapter must put in writing the job duties and responsibilities it wants the lobbyist to perform. Creating a blueprint will provide the lobbyist not only with direction, but also a clear level of expectation. The chapter should also design a performance assessment to measure if job responsibilities and expectations were satisfactorily met. The lobbyist should be required to provide detailed reports to the chapter on the progress of various bills.
You may also want to consider the following questions:
- Are the services for a single issue, or will the lobbying firm be representing the radiologists' interests on all matters? Does it cover monitoring only or does it also include active lobbying on a given issue?
- Who will determine what the prominent issues are?
- What are the details of your arrangement? If your chapter wants specific accountability for services rendered, you may request that an itemized estimate accompany the agreement. Make sure that the agreement spells out both the terms and conditions for payment. Determine up front whether the lobbyist will be providing both regulatory and legislative coverage or will be representing you in the legislature only.
- What is the term of the agreement?
- What provisions are in the agreement that cover possible conflicts of interest?
- Does the agreement allow the chapter discretion to replace the lobbyist if the chapter believes that another individual in the firm would represent the chapter's interests more thoroughly? Can the chapter designate the individual lobbyist to represent the chapter? Your chapter may want to note in the agreement how the lobbyist is to receive advice and take action, and who will serve as principal contact for the chapter. You may wish to designate the proper lines of communication to avoid confusion or conflicting information.
To best analyze the provisions in the agreement, you may want to have a separate legal counsel review the agreement before signing. Be sure to ask questions about the agreement and do not sign anything until you completely accept the provisions of the agreement.
