Hints for Influencing Legislation

Texas, June 2001

We were fortunate to have successfully passed legislation in Texas, which prohibits insurance companies from excluding coverage for cognitive therapy as a medical necessity for brain injury survivors, and requires training in the understanding of brain injury for pre-certification personnel who are responsible for approval of insurance claims within our state.

In the hope that our experience might assist your state in legislation benefiting brain injury survivors, we have written a few suggestions learned from our recent experience. You might not choose legislation that involves insurance reform, as ours did, choosing perhaps better prevention laws (bike helmets, etc), state funding (maybe for rehab centers), or education (both public and private schools). But these suggestions would hopefully adapt to whatever you choose.

  • Meet with several groups within your state to define the single most important issue you'd like to address within the Legislature.
    • Make your appeal as simple as possible
    • Clearly document your reasons for the request
    • Keep your aim as broad as possible (i.e. don't ask for legislation for TBI if you really mean acquired brain injury.)
    • But specify that you are not requesting coverage for everything so you won't scare the opposition too much (i.e. if you were to ask for better made football helmets, make sure the coaches know you don't really mean to exclude football from high school program.)
  • Find a Representative and/or Senator to file your bill.
    • If yours is a bicameral body consider joint filing in both houses simultaneously.
    • Locate a Representative or Senator who is a member of the committee to which your bill will be referred(in Texas, the House of Representatives refer all bills dealing with insurance reform to the Insurance Committee.)
    • Especially seek someone from the more conservative, far right members of your legislative body. You will likely have the support of your progressive members.
  • Find members of your legislative body who have a personal interest in brain injury and contact them for their early involvement.
    • Seek those that have carried similar legislation
    • Request their lobbying support
    • Ask their advice about other Legislators and Committee Chairs

These folks will make the difference between “foot dragging” and fast movement in various committees as your bill travels through the many steps along the way to the Governor's office for signing into law.

  • Get a respected group of people who will be able to make calls to Legislators, and who might be willing to go to the Capital to testify. Seek people whose name (and money) will have clout with the elected official, i.e.
    • Chairs of hospital boards,
    • Directors of the boards of Governors of area medical schools,
    • Members of various associations, i.e. American Psychological Association, CEOs of rehabilitation centers, AMA officials.
    • Major state physicians
    • Well known names in research, education, politics

With a little determination, you'll locate these important people who ALSO have a personal connection with brain injury or who's institutions are very interested in this legislation, such as the Chancellor of your Medical School.

Most importantly, locate a coalition of caregivers and associations of several types of brain injury groups, and create an effective means of frequent electronic communication with them, i.e.

  • Your state and local brain injury associations
  • Support groups such as TBI, cerebral palsy, shaken baby, brain abscess, stroke, brain tumor, multiple sclerosis, hypoxia, meningitis, etc.

These individuals were the fast acting e-mail voice of the grass roots effort that created success within the passage of our bill in Texas.

  • Take advantage of media coverage in several areas of your state.
    • Find local human-interest stories in the home-towns of the Legislators.
    • Involve your most articulate caregivers and survivors
  • Court the staffs of key legislators
    • Maintain close relationship with the assistants of the persons sponsoring your bill
    • Stay ever vigilant in your contact with them

Legislators, even those with different ideologies, have a special relationship with one another. If some of your spokespersons are Legislative colleagues whose daughter or grandson is a brain injury survivor or whose mother or husband is a success story, their personal testimony is tremendously helpful. Their treating team of doctors and therapists will make excellent lobbyists because the Legislator will make certain their story is heard.

Our bill passed because of the mixed blessing of recent brain injury experience of Representatives and Senators – both liberal and conservative - who testified of their successful cognitive treatment done without the insurance coverage we were requesting. These Members represented the full political spectrum of our state government. Their personal involvement was the key to preventing stalled or bottlenecked legislation.

We wish each state the best of luck in efforts to support the needs of the brain injury survivors and their caregivers throughout our nation. Share with us your success stories, please.

Ralphana Barnes Educational Liaison Center for Brain Health UTDallas/ Callier Center for Communications 1966 Inwood Road Dallas, Texas 75235 214-905-3007 214-905-3026 FAX

To find a copy of our bill on line, look at http://www.capitol.state.tx.us/

Click on Bill Information on the left of the page.

Type in “HB 1676” and check “text” and click on “select”

At this same site you will see

Legislative Resource; Texas Statutes, Texas Constitution, Index to Sections Affected, TLC Drafting Manual

Your state site (which should have an address similar to ours) should have information similar to this to offer you. Check the drafting manual for step-by-step writing info.

The National Brain Injury Association http://www.biausa.org/ will assist with advice through their legislative consultants, as well.

Good Luck.

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