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The Need for a Change

The lobbyists from the three voluntary health agencies—American Cancer Society (ACS), American Lung Association (ALA), and American Heart Association (AHA)—organized a series of fall meetings led by AHA to plan a strategy for the Proposition 99 reauthorization fight. They needed focus, energy, and resources. As Paul Knepprath, who had joined Tony Najera as a lobbyist for the state ALA in 1995, explained, “What we needed the next go around was not a pure sort of traditional legislative lobbying campaign but rather a campaign that included other elements that brought the public pressure from the outside more. …There was a consensus that we needed to do things differently for reauthorization than what we had done in the past. There was consensus on bringing in new players and new partners, which I'm not sure which ever came to fruition.”[2] Beyond acknowledging that something had to be done differently, there was little activity.

This lack of action on the part of the voluntaries was confirmed for the local lead agencies (LLAs) in a monthly technical assistance telephone call hosted by the American Nonsmokers' Rights Foundation (ANRF), the educational arm of Americans for Nonsmokers' Rights (ANR). The service was part of the technical assistance provided by ANRF under contract to the Tobacco Control Section (TCS). ANRF director Julia Carol used this forum to let the LLAs know what was happening on reauthorization. Carol attempted to use an early fall teleconference to bring the LLAs together with the ACS:

ANR's plan was to have nothing whatsoever more to do with any statewide efforts, we were just doing our work. But I still wanted to look out for the constituency we serve, so I invited the Cancer Society to come on the line and give an update on the plans for reauthorization for Prop. 99. …I was trying to get these people to look to the Cancer Society for leadership and not to us and that these people were very mistrustful and that they needed to know that something was going on and they needed to be included. They needed to be a part; they're tired of being left out. They're suspicious of deals being cut in the dark and of people not telling them things.

So really there needed to be a frank conversation with them about what the plans were and what they could or couldn't do, what the communities could or couldn't do. So…I asked Theresa [Renken, the ACS lobbyist] to give an update and she said, “Well you know, we're going to be forming a coalition and we're going to be talking about blah and we're going to have a big meeting in the fall and we're going to do this and that and by November we'll do the other and the Legislature is gone and they'll come back and blah and blah and blah.”


And I said to her, “What's our plan in the meantime, right now?” And I meant for influencing the budget language before the budget comes out, but I didn't say that. “What's our plan now?” And she said in a very snotty tone, this is a teleconference with over one hundred people on it, “Well, Julia, if you understood the legislative process you would know that the Legislature is about to be out of session. So there is nothing that can be done until they return anyway.”…

So I said to her, “Theresa, it sounds to me like the campaign is going to be run much the same way as it has been the past, is that correct?” And she said, she paused and said, “Well, yes.” And I said, “I see. …well then, if you are going to do things the same way, what makes you think you are not going to get the same results?”[3] [emphasis added]

The Sacramento lobbyists who had negotiated the implementing legislation for Proposition 99 over the years still did not appreciate the need to actively engage the grassroots or the power of doing so.

Tony Najera, who, with John Miller, had headed the “inside” game on behalf of the health organizations since 1989 and the passage of AB 75, revealed why the inside game was played the way it was: “Paul [Knepprath] would from time to time criticize me and rightfully so because he wanted me to include other parties. And I would always say, `That's nice to be inclusive and to bring people along. However, there are times where you have personal relationships and…they don't want other people. They want to be able to confide, quietly tell you what they think.'”[2] Najera was sensitive to his role in the inside game: “I've been accused of giving away the store by people that don't understand this game. I consider that a false accusation which is very unfounded.”[2]

Steve Scott of the California Journal observed that the behavior of the voluntary health agencies' lobbyists was typical of the tendency of the lobbyists in Sacramento to live in their own world:

As somebody who covers the Capitol, I can't be too critical of the way they [the voluntary health agency lobbyists] approach the Legislature. …You tend to become a product of the system in which you operate and over time I'm sure that these lobbyists are no different from any other lobbyists. Over time you become inculcated into the culture and you start to think in incremental terms rather than in bolder terms. But that's why you have grassroots. …Ultimately the lobbyists are employees. And if the people who employ them don't look beyond what they are telling them, then they are not doing their members any good service either. So I don't think that the grassroots arms of the organizations can be exempted from a share of responsibility for allowing the Prop. 99 situation to atrophy the way it did. Because the repository for all wisdom isn't the lobbyist in Sacramento.[4]


Thanks to Proposition 99, the TCS and ANR leadership, and the LLA directors, the local tobacco control coalitions were getting stronger and more organized. They could not understand why the lobbyists in Sacramento were not reaching out to tap this power.

At the same time, things were changing at the AHA in a way that would lead to a much stronger appreciation of the grassroots. Mary Adams had recently replaced Dian Kiser as AHA's lobbyist. While Adams had been involved in the early Proposition 99 fights as the ACS lobbyist (as Mary Dunn), she had lived in Europe for several years and had only returned to Sacramento in November 1994. She was surprised at how far the Proposition 99 allocations had deviated from the terms of the initiative. In crafting a legislative strategy for 1996, Adams felt that the voluntary health agencies needed to open up the process and involve new people, particularly those in the field who had been fostered by Proposition 99's community-based activity.[5] She also recognized the need for the tobacco control advocates to be more nonpartisan and bipartisan:

I wanted to have both Democratic and Republican representatives. Because in the past, we'd just always focused on the Democrats and I felt like that wasn't going to get us where we needed to go. …I started communicating to my organization after meeting with this group and I hawked the same three points all the way through with this group that I had drawn together and then with my own organization: that we needed to have an intensive grassroots effort,…that we had to have intensive use of the media to get the public to focus on the issue, and that we needed to have a contract lobbyist with Republican ties who would be able to work the issue for us in a successful way. And then I shored that up with just my strong feeling that this was all going to take place through the budget, that it was not going to go through the normal legislative track.[5]

Having been absent from the battles in Sacramento over the past few years, Adams had an easier time recognizing strategic errors that the voluntary health agencies had made: “The strategies that had been used in the past…had been dismal failures. When I left, there was a ton of money coming. When I came back I saw the whole thing in a real mess. I knew that we had to draw together many more facets, many more approaches than had been used in the past.”[5] Adams wanted a more aggressive campaign to defend Proposition 99 that reached well beyond the Capitol building and was determined to get ANR and its past president, Stanton Glantz, on board.

But involving Glantz and ANR was not just a matter of adding their names to a coalition letterhead and proceeding with business as usual.

Neither Glantz nor the ANR leadership had much confidence in pursuing the kind of insider game that had failed for the last several years. They were committed to action with a strong grassroots component based on their experience doing battle over Propositions 5, 10, and P and passing hundreds of local ordinances. They also recognized the central role that the CMA and other medical interests had played in legitimizing the diversion of money out of the Health Education and Research Accounts; they viewed neutralizing the CMA as the crucial first step to restoring Proposition 99. But they doubted that the voluntary health agencies would have the nerve to confront the CMA, much less the governor or the Legislature.

ANR had built its reputation as a grassroots organization by being a confrontational outsider. Even if it could be persuaded to change its focus from local ordinance fights, its preferred strategy, to a state-level one, it would certainly not compromise its style in the process. ANR had its own vision of what was needed in the Proposition 99 fight. According to ANR co-director Robin Hobart,

One thing that we realized was that the only way you were going to see real reauthorization of Prop. 99 at the full level—and this was based on our experience with [Proposition] 188 in some ways—was that you're going to have to run it like an election campaign, not like just any old bill. It had to really be a campaign with all the attendant grassroots strategy and media strategy and inside-the-Capitol strategy. …The other thing that we knew based on how the governor had responded and the Legislature responded to our lawsuits—we were successful in court but having absolutely no effect whatsoever with regards to what the Legislature was prepared to do—was that it was going to have to be a real gloves-off campaign. People were going to have to name names. And the California Medical Association was going to have to be forced to get out of the way.[6]

ANR could envision an effective strategy, but it had no intention of actually getting involved. Hobart continued, “We didn't believe that it ever was going to happen and so to a certain extent, we decided, `It's really awful, it's really a shame, but ANR has absolutely no ability to do anything about any of this by ourselves and we're done.' We gave at the office, the lawsuit was the last thing that we made a commitment to do to try to save Prop. 99 and after that, we were done.”[6]

Glantz also saw the need for a more confrontational strategy but was more willing to get involved. In a 1996 interview he said,

And what happened last year [in 1995] was I saw the whole program just going down the drain. I think the CMA and the Tobacco Institute were coming

in for the kill. …The program was in a complete shambles, because local lead programs had basically been dismantled, because the media campaign was a mess. And the tobacco companies and the Medical Association had succeeded in turning this into a fight about money, and a fight about money is not news in Sacramento. And Tony [Najera] and John [Miller] and the others up there were still pursuing the same old insider strategies where they'd been screwed every time. Just all the tea leaves were looking bad. …I sat back and I said, “Now,…am I going to sit here and chronicle the demise of this program while watching it and have a nice clean paper where I've written about how the thing went down the drain?”…I just decided I could not stand to sit and watch this thing go down the drain because I thought it was just too important.[7]

Meanwhile, as AHA was trying to recruit ANR and Glantz, ACS was engaged in its own discussion about reauthorization. According to Don Beerline, a past chair of the ACS California Division, ACS also recognized the need to do something different:

What the ACS decided early last fall [of 1995] was that we had been unsuccessful. The advocacy in those previous reauthorization campaigns had primarily been carried out by our professional lobbyists. The lobbyists in those previous campaigns have complained somewhat that they didn't feel like they really had the support to do what they needed to do. And given the past history of that failure, the ACS said, “We need to do something different this time.” The debate went on within the ACS, and it culminated when our board of directors in November of 1995 committed $120,000 for this campaign plus obligated one individual full time for the first six months of 1996, and this is not a clerical person. This was a middle manager. So that's a significant commitment of personnel and funds compared to the last time, the assumption being with that sort of commitment then we would become, for the first time, the lead agency in this fight. And in the past, it has been other organizations have been considered the lead agency. And that is exactly what happened. …Lung Association definitely and their representatives were definitely not happy when ACS took the role of the lead agency in this and decided that we needed to have a different strategy.[8]

Although everyone had the same goal—full funding of the Health Education and Research Accounts—there were no indications that their plans to achieve those goals meshed.

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