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TABLE
OF CONTENTS
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WITH
EYES WIDE OPEN…KEEPING FUNDS DEDICATED TO TOBACCO CONTROL
AND PREVENTION
GREETINGS FROM DEARELL
Welcome to the first edition of TTAC Exchange – a
technical assistance tool that goes beyond information sharing.
On a quarterly basis, TTAC Exchange will offer fresh insight,
take an honest and direct approach in bringing you information,
strategies, and tools, and provide a gateway to resources on current
tobacco control issues.
This issue of the newsletter addresses what you can do to prepare
for upcoming funding challenges. As state fiscal conditions continue
to deteriorate, tobacco control advocates will be facing more tough
battles to maintain funding for tobacco control programs. We felt
there would be value in reviewing what occurred last year in some
of the states hit by funding cuts, gleaning insights that you can
use proactively to assist advocates in efforts to maintain or increase
funds devoted to tobacco control.
No newsletter can provide the solutions to all your funding dilemmas.
But we do hope this edition prompts you to ask some tough questions
and spurs you to seek viable answers. Take what you learn, put the
issues on the table for discussion with key people in your organization,
and get ready to confront reality.
There will always be challenges, new players and a changing political
landscape. The right people equipped with the right tools can create
a climate that tips the scales in our favor. Do you have these people
and tools? It’s time to find out.
-Dearell Niemeyer, MPH, Executive Director, TTAC
Back to Table of Contents
The problems
of today cannot be solved at the same level of thinking
that created them.
--- Albert Einstein
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FUNDING
UP, FUNDING DOWN
The tobacco control fiscal landscape remains a kaleidoscope in constant
motion, with tobacco control program funding in jeopardy of being
on the chopping block.
Some state programs survived strong challenges and maintained or
increased funding allocations in 2002. However, the overall cuts
realized by other states far exceeded the increases. Of particular
note, California, Massachusetts, and Arizona – states historically
exemplified for their successful programs – each suffered
significant program cuts.
States are continuing to maneuver the often troubled funding waters.
Some states have addressed funding issues by raising tobacco excise
taxes – a desirable policy maneuver, whether revenue generated
is directed to tobacco control programs or not, because higher cigarette
prices result in fewer smokers and lower health care costs. On the
other hand, many states have found themselves navigating through
shifting tide waters – those of partial or full securitization
of tobacco settlement funds. These states have favored the “selling
off” of future settlement payments to ease state budget deficits
of today – creating shortsighted fiscal policy of not looking
to the future…even the future right around the fiscal corner.
Back to Table of Contents
TTAC
talked with tobacco control folks in three states that
endured funding challenges and losses. Read on for a
summary of local and state-level perspectives on what
really happened in Wisconsin, Maine and Arizona. |
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UP
CLOSE AND PERSONAL WITH WISCONSIN, MAINE AND ARIZONA
• Wisconsin
• Maine
• Arizona
Wisconsin
– All MSA funds were depleted to cover state budget deficits.
The
Budget Skinny
Facing the first budget deficit in more than
a decade, Wisconsin legislators, in 2001, decided to securitize
all 25 years of payments from the Master Settlement Agreement (MSA)
($5.6 billion) in exchange for a $1.3 billion lump sum payment.
This payment helped cover the budget deficit, with $500 million
used to establish a tobacco prevention endowment fund.
In 2002, as lawmakers
continued to face a budget deficit, they chose to deplete the endowment
fund. The same statute boosted tobacco prevention funding to $25
million; however, with no MSA funds available, monies for all future
efforts must be appropriated from the state’s general operating
revenue.
The ‘Insider’ Perspective
TTAC spoke with Wisconsin tobacco control advocates and staff who
shared their thoughts on what contributed to the situation.
Contributing factors included:
- The overall political environment, including a new and inexperienced
governor, and the sheer complexity of the securitization issue,
made it a very difficult battle.
- Lawmakers confronting a $2 billion budget deficit while anticipating
a competitive election season.
- Many newly funded programs and newly formed local coalitions
that lacked the capacity, support, and expertise to provide the
strong grassroots presence to fight securitization.
- The vulnerability of the state’s program, in part, because
tobacco control lacks the specific constituency that many other
statewide issues enjoy.
Key areas cited as needing more focused attention in Wisconsin’s
tobacco control environment include:
- Better collaboration among partners
- Mobilization of local opinion
- A re-emphasis on the ethics of public policy
- Better collaboration and coordination of resources, knowledge
and accountability
- The need and importance of educating and training local coalitions
on the value of public policy advocacy
One strategy that has been successful in state
efforts to hold on to their MSA monies is to diversify the dollars
over many programs representing many constituencies. This makes
it more difficult for legislators to seize these funds to fill budget
gaps.
Tobacco Control Plans a Comeback
As grim as the situation in Wisconsin may sound, tobacco control
advocates are setting their sights on the future – concentrating
efforts on increasing the cigarette excise tax in the next legislative
session. This campaign – The Wisconsin Children’s Initiative
(WCI) – is focused on raising the excise tax by 85 cents,
which would result in revenue to fund tobacco and other health-related
initiatives, and a substantial reduction in smoking. The WCI is
poised to broaden and diversify the existing statewide coalition
and make the tobacco issue more politically potent.
Special thanks to:
Catherine Brue, Tobacco Project Manager, Division of Public
Health, Dept. of Health and Family Services
Aaron Doeppers, Regional Advocacy Representative at the National
Center for Tobacco-Free Kids
Shannon Guernsey, Regional Advocacy Manager, American Cancer
Society
David Gundersen, Executive Director of the Wisconsin Tobacco
Control Board
Geralyn Karl, Tobacco Prevention and Control Specialist, Pierce/St.
Croix County Tobacco Free Coalition
Carrie Sullivan, Executive Director of SmokeFree Wisconsin
Maine
– Nearly 39% of current MSA monies diverted to cover budget
deficits
The Budget Skinny
The Fund for a Healthy Maine (FHM) was created to receive and disburse
Master Settlement Agreement dollars over a very broad range of health-related
programs. In 2001 and 2002, the FHM took a hit to compensate for
Maine’s budget woes. Nearly 39% of the MSA monies that Maine
has already received have been diverted for other uses.
The ‘Insider’ Perspective
Though the FHM took a hit this past fiscal cycle, tobacco control
advocates, in union with advocates from other health-related programs,
attribute their success in protecting the balance to a number of
reasons:
- The Fund is earmarked for a very broad range of health-related
programs, including childcare, prescription drugs for the elderly,
and school health programs.
- The Maine Coalition on Smoking or Health polled state voters
and found that 82% of those surveyed supported using the FHM for
health-related purposes, and 78% opposed using the FHM to balance
the state budget.
- The Maine Coalition on Smoking or Health launched a major campaign
to ask legislators (to ask each other) to sign a pledge to permanently
prevent the further diversion of tobacco settlement monies away
from the FHM.
- Local coalitions organized under the guidance and direction
of the Maine Coalition on Smoking or Health spoke with a strong,
single, unified voice.
Tobacco Control Plans for the
Future
Tobacco control advocates in Maine are fully aware that the funding
landscape is never secure. They continue to work toward protecting
the Fund for a Healthy Maine through contacts with legislators (particularly
newly elected ones), and by focusing on specific public policy goals,
including:
- reducing exposure to secondhand smoke;
- ensuring that all Maine insurance companies cover cessation
pharmaceuticals and counseling; and
- assessing the use of financial disincentives as a tool to reduce
youth smoking.
Special thanks to:
Judy Dorsey, Senior Policy Analyst, Maine Coalition on Smoking
or Health
MaryBeth Welton, Program Manager, Partnership for a Tobacco
Free Maine
Tina Harnett, Director, Healthy Androscoggin
Arizona
– Nationally recognized Tobacco Education and Prevention Program
revenues reduced by 50%.
The Budget Skinny
Unlike Wisconsin and Maine, Arizona’s Tobacco Education and
Prevention Program is funded solely through tobacco excise tax revenue.
However, this does not protect them from funding cuts in times of
state fiscal deficits.
In 2002, Arizona faced $500 million budget deficit. Fearing tobacco
control program funds were in jeopardy, the tobacco control community
mobilized an intense lobbying and media advocacy campaign, but unfortunately
were unsuccessful. Total funding for the state’s Tobacco Education
and Prevention Program was cut 50%.
Tobacco Control Kept Moving
While the budget cuts were occurring, several nongovernmental organizations
responded by forming the coalition, Arizona for a Healthy Future.
The coalition’s efforts aided in the success of getting the
Arizona legislature to put Prop 303 – a proposition to more
than double the tax on cigarettes – on the November 2002 ballot.
The proposition passed easily, raising the tax to $1.18 per pack.
Though the increased revenue is not earmarked specifically for tobacco
control, the proposition contains language that reinstates funding
for the state tobacco control program to previous levels, locking
the dollars in place so that they cannot be used for other purposes.
The ‘Insider’ Perspective
on Success
TTAC spoke with Arizona tobacco control advocates and staff who
shared these thoughts on factors that contributed to the proposition's
success.
- The timing of the proposition was one key to its success. This
included an analysis of the public’s readiness for the tax
hike and the knowledge of what other propositions would be on
the ballot.
- Everyone gained with its passage. It provides new funds to the
state for needed programs, the Tobacco Education and Prevention
Program’s funding is protected, and smoking rates will decline
significantly.
Special thanks to:
Susan Kolbe, Field Director, Arizona for a Healthy Future
Jesse Nodora, Tobacco Education and Prevention Program
Bill Pfeifer, President and CEO, American Lung Association of
Arizona
Back to Table of Contents
The
experiences of Wisconsin, Maine and Arizona reveal several
common and ever challenging issues that tobacco control
communities across the country continue to face. The
experiences of these and other states magnify the importance
of finding ways to address these issues now so that
tobacco control can be better prepared to meet fiscal
challenges head-on. Read on for a discussion with the
experts on what new strategies states can think about
to work through some old issues. |
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OLD
ISSUES GAIN NEW PROMINENCE – EXPERTS CHIME IN
Four common challenges emerged during our
interviews with the states: (a) Communication and
Collaboration; (b) Building and Broadening
Constituency; (c) Marketing Success; and
(d) Emphasizing Advocacy. These challenges,
though not unfamiliar, take on new importance and prominence in
the current and future fiscal landscape of tobacco control.
We asked two experts for fresh insight on how states can face these
challenges and prepare for another legislative session. Here’s
what C.B. Pearson, Senior Vice-President of M&R Strategic
Services, and Jeannette Noltenius, Vice-President of Swartz
and Associates have to say.
(a) Communication
and Collaboration
Tobacco control programs continue to identify communication
and collaboration as one of the most difficult and challenging aspects
in the efforts to secure funding.
What specific recommendations
or actions can you make to all state programs to establish clear,
effective communication and collaboration between partners before
a legislative session begins?
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C.B.: To establish clear and
effective communication, it is necessary to have a written
strategic plan in place far in advance of a legislative session.
This plan will include an organizational structure with clearly
defined roles and responsibilities for coalition members and
government employees at both the state and local level. Once
this structure is in place, don’t reinvent the structure
every year, but realize that it can change. The tobacco control
community is at an extreme disadvantage if it tries to define
this structure during the legislative session. |
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Jeannette: It is not possible
to work together in a crisis situation without first establishing
long-term relationships. Advocates must first “work
together before they can do battle together.” This is
a long-term process that involves building trust and truly
understanding the interest, abilities, and restrictions of
all parties. |
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(b) Building
and Broadening Constituency
As states continue to face dire fiscal situations,
difficult budget cuts are certain. Building and broadening constituency
by aligning tobacco control with other health and social concerns
is a strategy that can help protect funding.
What key factors
must be considered when partnering to build and broaden constituency?
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C.B.: It is important to realize
that building a broad constituency is a strategic decision.
It needs to be clearly understood why certain groups are being
invited to the table, what they are going to contribute, and
how they are going to contribute. Rather than having one “super-coalition”
and hope that everyone goes along with the mission, it may
be better to have “strategic coalitions” based
on one issue, such as raising the tobacco tax, which will
involve deeply committed partners. |
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Jeannette: First, before you
get started, look and be sure that the team you want to put
together reflects the community you work in. Do you have a
minority community that should be included, and/or a powerful
LGBT group with a successful record? How can you include them?
Second, look at the history of what groups have been successful
in the field of social justice, and what their needs are.
Look at ways the tobacco control community can support these
groups in their efforts, and not just how they can support
us. For example, if a state has a powerful and successful
teachers union, look at what their needs are, such as after-school
curricula, and find a way to fill that need. This will build
and broaden constituency. Give, before you expect to receive.
Invest before you ask support. |
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What are some specific
and effective methods that can be used to make legislators responsive
to their constituency?
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C.B.: There are, of course,
many methods: constituent meetings, town meetings, phone calls,
public opinion polls, and the like. The key is not being afraid
of putting pressure on legislators. In the past, public health
advocates spend about 90% of their time persuading legislators,
and about 10% of their time putting on the pressure. This
equation needs to be flipped. But to effectively put the pressure
on, a plan must be implemented to “bring out the numbers,”
in terms of the number of people at meetings and rallies,
the number of people to make phone calls, etc. People don’t
just magically appear – it must be well-thought out
in advance how many bodies are needed, and what needs to be
done to get them there. |
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Jeannette: When a legislator
is looking at the tobacco control movement in his district,
does he see voters, or paid lobbyists? Don’t be afraid
to put a human face in front of the legislator. People are
the real constituency. Don’t be afraid to use local
people who are not experts. For example, invite a mother dying
of lung cancer, to help frame your issue – her case
makes for a good human interest story, and may garner editorial
support. Legislators respond to human interest stories, particularly
when the stories are about people in their own district. Sometimes
it is not always the number of constituents, but the strength
of the message that counts. |
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(c) Marketing
Success
All too often, tobacco control program successes
aren’t heard or noticed when it most counts. Developing a
strategy to market the successes of tobacco control and prevention
is critical to protect program funding.
What are the most
important kinds of successes to highlight to legislators?
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C.B.: The most important kinds
of successes to highlight to legislators are those with a
human face. All too often, successes are presented in the
form of written summaries and bulleted points. Legislators
need to see the human face of these successes in their own
districts. |
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Jeannette: The most important
kinds of successes to highlight with legislators are the successes
that make them look good. Legislators want to look fabulous
to their constituents; they are always cultivating voters.
As tobacco control advocates, we have to remember that the
legislators are the actors, and it is our job to provide them
with the lines and the stage to make them look good to their
constituency by supporting legislation that will protect children,
build community, and lower health costs. |
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What are some of the best strategies
to effectively communicate these successes?
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C.B.: Several months prior
to a legislative session, consider doing a “show and
tell.” Have an open house of an agency or clinic and
literally show the legislators the successes of your program.
Be creative in how to market your successes, and stay away
from the theoretical. |
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Jeannette: We can communicate
our successes and make our legislators look good by providing
them media coverage and interviewing them in our newsletters.
Give the legislator a nice plaque or framed diploma that he/she
can put up in the State Capitol. Organize a dinner and an
award for the legislator. Invite the press, take pictures
and send press releases to all of the newspapers, especially
the local weekly news, so the legislator reaches his/her constituency.
It is a way of saying thank you, and making our case at the
same time. |
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Where can we find
cutting edge, state-of-the-art tools for effectively communicating
our successes with legislators and the public?
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C.B.: Ask legislators and
the public what is the best way to communicate with them.
Ask them what type of media works and what doesn’t.
Look to your own community for state-of-the-art tools and
methods. The point is don’t just adopt a “state-of-the
art” tool unless you are certain it will achieve your
goals. |
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Jeannette: There are several
good websites and resources for guidelines on how to communicate
with legislators and the public and on how to mobilize and
organize the community. The Advocacy Institute publishes Advocacy
for Social Justice: A Global Action and Reflection Guide,
which can be ordered from their website at www.advocacy.org.
The Midwest Academy publishes Organizing for Social Change,
which can be found at www.midwestacademy.com.
The Praxis Project also provides useful tools and publications
and can be found at www.thepraxisproject.org.
To reach people of color and/or priority populations contact
www.appealforcommunities.org
and www.outofmany1.org.
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(d) Emphasizing
Advocacy
In recent years, public policy advocacy –
the process by which public policy is changed – has been recognized
as key to the success of tobacco control and prevention efforts.
The challenge is to understand the importance and process of public
policy advocacy.
How exactly does
lobbying differ from public policy advocacy?
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C.B.: In short,
lobbying is when you actually ask a legislator to vote a certain
way on a specific bill. Advocating for a public policy is
everything but the asking – it is the information, the
education, the persuasion, all of which set the environment
for public policy discussions, but not the actual “ask.” |
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Jeannette: Advocacy
is the lead-in, the preparation. Lobbying refers to specific
bills and specific requests for writing, introducing, or amending
a piece of legislation. |
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What are the top
3 most important lessons when engaging in public policy advocacy?
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C.B.: Decide
what your goal is, develop a strategic plan to reach that
goal, and then execute that plan. Be ready to be persistent. |
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Jeannette: Know
your legislators and know what is important to them. Know
your constituents and what is important to them. Facilitate
this relationship between legislators and constituents. Realize
that this is a process which takes a lot of front-end time.
If you and your constituents have a good relationship with
the legislator and a good relationship amongst yourselves,
consensus and support are easier to attain when a specific
legislative bill is in doubt and negotiations get tough. |
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Back to Table of Contents
The
experiences and lessons learned from Wisconsin, Maine and
Arizona, as well as the suggestions provided by the experts,
can help states prepare for and better maneuver the next legislative
session with eyes wide open. |
TTAC
CAN HELP
TTAC is available to help you build your advocacy
base to defend your funding.
TTAC services include tailored consultation and training to help:
- Develop communication plans
- Train spokespeople for media encounters
- Mobilize local advocates
- Improve collaborations with partners
- Clarify organizational boundaries in educating, advocating,
lobbying
- Develop political strategies
Whether you need short-term consultation via telephone
to get your own creative juices flowing, or longer-term, on-site
assistance developing your team's skills in planning and advocacy,
TTAC can work with you to build your capacity for success.
For more information:
Online: http://www.ttac.org/request/int.html
Email: ttac@sph.emory.edu
Phone: 404-712-8474
Back to Table of Contents
RESOURCES
AND LINKS
State
Funding Informational Resources
Advocacy and
Lobbying Resources
- Activism,
Advocacy, and Diplomacy
Slide presentation, Sally Herndon Malek, MPH, 2002.
- Advocacy
for Social Justice: A Global Action and Reflection Guide
Manual and toolkit, Advocacy Institute
- Advocating
for Tobacco Policy Change
A step-by-step toolkit with detailed worksheets, available for
download from The Praxis Project website.
- E-Advocacy
for Nonprofits
The law of lobbying and election-related activity on the Net.
Published by Alliance for Justice.
- Health
Policy Coach
Center for Health Improvement site that includes a collection
of prevention-focused policies and a comprehensive resource guide
that walks you step-by-step through the policy-making process.
- Increasing
Tobacco Taxes: A Powerful Weapon for Reducing the Burden of Tobacco
Alan Ernst, 2003.
- Moving Toward Health: Achieving Parity
through Tobacco Control for All Communities
Toolkit available to order from Asian Pacific Partners for Empowerment
and Leadership (APPEAL), c/o AAPCHO, 439 - 23rd St., Oakland,
CA 94612, phone (510) 272-9536, ext. 121
- Nonprofit
Advocacy
Project of Alliance for Justice, website with resources for those
interested in the rules governing lobbying and election-related
activity by nonprofits.
- Organizing
for Social Change
Midwest Academy Manual for Activists. Comprehensive 425-page manual
on how to organize.
- Tobacco
Tribune
An e-journal published by the American Lung Association. Updates
on tobacco control initiatives, advocacy and legislative rulings.
To subscribe, go to www.lungusa.org/pub/.
Click on Online Newsletters.
- Worry-Free
Lobbying for Nonprofits
How to use the 501(h) election to maximize effectiveness. Published
by Alliance for Justice.
Presentations
on Advocacy and Funding from the 2002 National Conference on Tobacco
or Health
To access the handouts or slides from the following
presentations, link to the topic and scroll down below the abstract
where you can click on links to open these documents.
Back to Table of Contents
Coming in
the April issue:
Achieving
Parity in Tobacco Control
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TTAC Exchange Staff:
Linda Schuessler, Project Specialist
Aliki P. Weakland, Editor in Chief
JoAnn Weiss, Staff Writer
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