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Public Health Advocacy: The View from Inside State Government

posted on Thu, Mar 29 2012 10:20 am by Cliff Rees


I recently completed my seventh year as a legislative analyst for the Senate Public Affairs Committee of the New Mexico Legislature. This experience followed my twenty-three year career as an attorney for the New Mexico Department of Health (NMDOH) where, among other duties, I was actively involved in drafting public health legislation and testifying for those bills on behalf of NMDOH. Having sat on both sides of the legislative witness table, which I often refer to as “the hot seat,” I share with you my inside perspective as a public health attorney and legislative staffer.

The public health legislative topics my clients asked me to undertake were often controversial: HIV testing, confidentiality and job discrimination protection; behavioral health system reform; emergency medical services system reform; enactment of new public health emergency response powers; and, my most challenging endeavor, enactment of a compassionate use medical marijuana act.

I realized late in my career that the advocacy skills I learned as a law student and practicing attorney were ill-suited to the legislative arena. Attorney advocates in the adversarial judicial process seek to “win” a case by persuading a judge, jury or hearing officer that our client is “right” and the opposing party is “wrong” on the law and facts. The goal in the legislative arena, by contrast, is to pass a bill through the legislative “gauntlet” of committees and floor sessions with only a simple majority needed at each stop along the way to keep your bill alive so the Governor would have the opportunity to sign after passing both Houses.

Adversarial arguments tend to “turn off” legislators to whom they’re directed. They want to be assured that the bill, if it becomes law, constitutes good policy and that there will be minimal, if any, negative repercussions to their reelection chances if they support the bill. Legislators during regular legislative sessions are often very busy, multi-tasking and in various stages of information “overload” and fatigue. The “ABC’s” of legislative advocacy are therefore crucial to successful advocates: be “accurate, brief and courteous.” Long-winded arguments, PowerPoint presentations, demonstrative evidence, such as enlarged charts and graphs, and stacks of technical documentation are not welcome in our state legislative committee rooms when presenting a bill.

Public health leaders, Peter Jacobson and Patrick Libbey, recently engaged in a Point/CounterPoint  editorial for the bimonthly University of Michigan School of Public Health publication “Findings,” Fall/Winter 2011 about how public health actors should exercise our “voice” in the face of relentless budget cuts and controversy about the role of public health in contemporary society. Jacobson argues that public health actors have limited public influence due to fragmented advocacy for public health issues. Libbey counters that speaking with a single voice is insufficient; public health must better learn how to influence elected officials by, for example, influencing the electorate.

Both positions posit the need for better advocacy by public health on the vital issues of the day, ranging from public health sustainability to health in all policies. Strategies to achieve this goal will be the subject of a panel titled “Education, Advocacy and Lobbying” at the upcoming National Public Health Law Conference in Atlanta, Georgia, October 10-12, 2012. I welcome your comments and observations in advance of the conference.

This information was developed by Clifford M. Rees, J.D., practice director for the Network for Public Health Law – Western Region at the University of New Mexico School of Law, Institute of Public Law. The views reflected in this blog are my own and do not constitute the official positions of the New Mexico Legislature, the Robert Wood Johnson Foundation, the Network for Public Health Law or the University of New Mexico School of Law, Institute of Public Law.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.

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