1. ACR 2016 Everything You Need to Know About Advocacy: First Time Capitol Hill Prep Chris Sherin Director, Congressional Affairs Monday, May 16, 2016

2. Financial Disclosures: Nothing to Disclose

3. Congressional Hill Visit Preparation  Logistics: Capitol Hill Day is Wednesday, May 18 th.  Bus Schedule:  Buses depart hotel for Capitol Hill every 15 minutes between 7:30 AM and 9:30 AM.  Home Base: Reserve Officers Association, 1 Constitution Avenue, NE, (Building located on the Senate side directly across the street from the Dirksen Senate Office Building).  NO LUGGAGE!  Bring Photo ID  Bring Business Cards  Lunch served at ROA  Return trips from Reserve Officers Association to hotel run every 30 minutes between 1:15 PM and 4:30 PM. 4:30 PM is the LAST BUS.  Metro Stops: Capitol South for House (Orange/Blue Line); Union Station for Senate (Red Line, walk across Columbus Circle towards the Capitol Dome). 3

4. Capitol Hill Security  Capitol Hill security isn’t nearly as intense as airport security.  All smart phones, keys, and other metal/electronic devices need to be placed on the security belt to be scanned.  All written materials need to be placed on the security belt to be scanned.  Most shoes and belts will not trip the metal detector.  Take one giant step through the metal detectors.  Friendly Reminder: NO WEAPONS of any kind should be brought to any Capitol Hill office building.  Even pocket knives could result in arrest. 4

5. Where Will My Meeting Take Place?  Unless you have a meeting with the House Speaker, Majority Leader, Majority Whip, Minority Leader, or Minority Whip, you will NOT be visiting the Capitol Building.  Instead you will meeting in one of three House Office Buildings:  Cannon, Longworth, or Rayburn House Office Buildings  Unless you have a meeting with the Senate Majority Leader, Majority Whip, Senate Minority Leader, or Minority Whip, you will not be visiting the Capitol Building.  Instead you will be meeting on of three Senate Office Buildings:  Russell, Dirksen, or Hart Senate Office Buildings  House and Senate Buildings are connected underground via tunnels.  Using tunnels enables you to skip security between House/Senate buildings  CANNOT go from House side to Senate side underground.  If time to kill, cafeterias in House (Longworth) and Senate (Russell) Bldgs. 5

6. House and Senate Buildings Sit On Opposite Sides of the Capitol Building Supreme Court Library of Congress Madison Building Library of Congress Jefferson Building House Hart Senate Office Building Dirksen Senate Office Building Russell Senate Office Building Rayburn House Office Building Longworth House Office Building Cannon House Office Building Senate Capitol Visitors Center Entrance Federal Center Metro N Capitol South Metro Union Station Metro (not on map) Reserve Offices Association

7. Who Will I Meet With on Capitol Hill?  While some of you may have the opportunity to meet with the Representatives/Senators, the vast majority of the meetings will take place with legislative staff.  Meetings primarily with Legislative Directors or Legislative Assistants  Congressional staff are the eyes and ears of elected official.  Although they’re young and may not be very knowledgeable about radiology issues, treat staff with respect.  Meetings typically last 30 minutes but may need to be cut short due to staff time constraints.  Be Prepared: Practice a short (5 min), medium (15 min), and long (30 min) speech.  Hallway meetings: Due to space and time constraints, meetings often occur in the hallway. DON’T BE OFFENDED!  You’re not a true Capitol Hill advocate unless you’ve done a meeting in the hallway! 7

8. Typical Congressional Office Staff Hierarchy 8 Member of Congress Chief of Staff Legislative Director/Counsel Legislative Assistants Communications Director District Director District Caseworkers Legislative Correspondent Staff Assistant Personal Assistant/ Scheduler Policy StaffCommunications Staff Office Staff District Staff Analysis Members of Congress are advised to structure their office into discrete areas, depending on their staffers’ functions Legislative Assistants handle multiple issue areas (e.g. health care, defense, social security, immigration, etc.) House Offices typically have 3-4 Legislative Assistants Senate Offices typically have 5-7 Legislative Assistants

9. Be on time Arrive no more than 10 minutes before the meeting; Members are rarely available to meet earlier and Hill offices are too small to accommodate lingering constituents Inform the Scheduler if you are going to be late in case another meeting time must be arranged Quick Takes Advocates can leverage face-to-face meetings with Members of Congress and their staff to communicate their positions and build enduring relationships with their representatives However, meetings are brief and Members are busy; advocates should keep the tips below in mind to get the most of their meetings Leave Behind Information Leave behind talking points on the issue discussed with the Member’s office; the document should serve as a helpful resource for staff as the issue moves through Congress Keep Politics Out of It Do not discuss elections or campaign support in your meeting; it intimates that the Member is “for sale” Respect the Member’s political views and relationships outside of the issue at hand Be flexible Prepare to meet with either the Member or the Member’s staff; treat both with equal respect If the Member arrives in the middle of your meeting, continue as usual; and the Member will ask questions if needed Stay on Topic Raise only the issue you scheduled to discuss with the Member and the Member’s staff to keep the meeting focused and persuasive Key Tips for Capitol Hill Meetings 1 2 XYZ ISSUE REPORT What to Keep in Mind When Conducting a Meeting with a Member of Congress 3 45

10. What If I Meet with a Senator/Representative?  If your Senator/Representative is scheduled to meet with you, make sure to stay on message and be concise.  Don’t fall victim to their “charm” and spend the full meeting talking about random local topics.  Specifically request the elected official to cosponsor the bills in question.  Don’t be nervous about making a specific request, they’re used to it and want to be responsive to constituents.  When the elected official speaks, you stop.  Leave the materials for the staff who accompanies the elected official.  Don’t be surprised if elected officials drop in during the middle of a meeting.  Why isn’t my Congressman meeting with me? 10

11. Schedules Leave Little Time for Focusing on Constituents Sample House Member Schedule* 9:30 AM – 9:30 AMSpeak to attendees of National Women, Infants, and Children’s Association (WIC) Leadership Conference 10:00 AM – 12:00 PMAttend appropriations hearing for FDA regulatory programs 10:30 AM – 12:00 PMAttend bipartisan classified briefing on Iran 12:00 PM – 1:00 PMAttend caucus meeting on jobs and the economy 12:45 PM – 1:15 PMMeet with WIC program manager to discuss issues and funding 1:15 PM – 1:45 PMMeet with representatives from the American Israel Public Affairs Committee to discuss U.S.-Israel aid 1:30 PM – 2:00 PMMeet with local county supervisor to discuss national parks bill 2:00 PM – 2:30 PMMeet with nonprofit representative to discuss food stamp initiative in state 2:30 PM – 3:00 PMMeet with local U.S. Army officers to discuss land transfer issues 3:00 PM – 4:00 PMListen in on fundraising call at party HQ 3:00 PM – 3:30 PM(FYI: regional Army Corp of Engineers discussing current projects) 3:30 PM – 4:00 PMMeet with organic farming research foundation to discuss farming programs 4:30 PM – 5:00 PMMeet with local supervisor to discuss health issues 5:00 PM – 6:00 PMMeet with local county representatives to discuss flood control efforts 6:30 PM – 9:30 PM(FYI: American Council for Capital Formation Dinner Discussion) Scheduled events often overlap Members may be late to meetings due to competing constituent demands for Member time

12. Key Legislative Issues for Capitol Hill Day  All radiologists attending the May 18 th Capitol Hill day will be discussing the following topics:  Provided your elected official voted in favor of the legislation, thank your Representatives/Senators for supporting H.R. 2029, the Consolidated Appropriations Act.  Bill lowered the PC MPPR from 25% to 5% and placed a 2-year moratorium on flawed USPSTF breast cancer screening recommendations  Cosponsor H.R. 1151/S. 1151, the USPSTF Transparency and Accountability Act  Bipartisan legislation to reform the Untied States Preventive Services Task Force’s (USPSTF) membership, research methodology, and public comment process.  Requesting Representatives/Senators cosponsor the bill  Cosponsor H.R. 4632/S. 2262, the CT Colonography (CTC) Screening for Colorectal Cancer Act  Bipartisan legislation to require Medicare to cover CTC, also know as “virtual colonoscopy  Requesting Representatives/Senators cosponsor the bill  Be sure to attend the Tuesday, May 17 th in-depth legislative issue briefing  Session will run from 3:30 PM-5:00 PM in the main Marriott Ballroom  First part of the presentation will feature an election analysis by Charlie Cook  Be sure to attend session to hear all key talking points pertaining to reforming the USPSTF (H.R. 1151/S. 1151) and promoting Medicare coverage of CTC (H.R. 4632/S. 2262) 12

13. Congressional Packets  All radiologists visiting Capitol Hill should pick up ONE “attendee” packet.  Personal packet of materials outlining key issue background and talking points for meetings.  Packets are available for pick-up after conclusion of this session or at the RADPAC booth.  Closely review this packet of materials BEFORE the Tuesday session and your Wednesday Capitol Hill meeting.  Tell all your colleagues who aren’t here today but are visiting Capitol Hill to get their attendee packet!  One designated radiologist from your state is in charge of picking up and delivering a packet to “leave behind” with each House and Senate staffer that you met with on Wednesday.  You are ONLY responsible for getting an “attendee” packet. 13

14. Congressional Packets Cont.  Attendee packet contents--  Issue: Thanks for H.R. 2029  Folder Contents 1. List of Representatives/Senators voting NO on H.R. 2029. *If your elected official is listed on the document, DO NOT thank them for supporting a lower MPPR or the two-year moratorium on the USPSTF breast cancer screening recommendation.*  Issue: H.R. 1151/S. 1151, the USPSTF Transparency and Accountability Act  Folder Contents 1. H.R. 1151/S. 1151 Issue Brief 2. H.R. 1151 Cosponsor List 3. Background document on 2009 and 2016 USPSTF Mammography Screening Recommendations 4. Copy of H.R. 1151/S. 1151 Bill Language 14

15. Congressional Packets Cont.  Issue: H.R. 4632/S. 2262, the CT Colonography Screening for Colorectal Cancer Act  Folder Contents 1. H.R. 4632/S. 2262 Issue Brief 2. H.R. 4632/S. 2262 Cosponsor List 3. Copy of H.R. 4632/S. 2262 Bill Language  Each attendee folder also includes a PowerPoint slide outlining other imaging/health care bills that are not the focus of Capitol Hill Day, however, Congressional staff MIGHT ask you them.  Do NOT bring these bills up to the Congressional staff  Only provide ACR’s position on each bill if Congressional staff asks a direct question on the legislation  ACR’s position on each bill is clearly outlined on slide  If you do not know the answer to a specific question, do not make up an answer; simply ask the Congressional staff to get in touch with ACR’s GR staff.  Get business cards for each Congressional staff you meet with 15

16. Additional Radiology Legislation H.R. 4614- the Medicare Access to Radiology Care Act. Lowers supervision requirements for Radiologist Assistants/Radiology Practitioner Assistants (RA/RPAs) and permits them to bill under the Medicare program “incident to” radiologists. ACR SUPPORTS this bill. (8 House cosponsors, currently no Senate companion bill). H.R. 6- the 21 st Century Cures Act/Senate HELP Committee’s “Innovations” Package. Large, bipartisan bill to provide additional funding to the National Institutes of Health (NIH), as well as streamline the Food and Drug Administration’s processes for reviewing and approving pharmaceuticals and medical devices. PENDING OFFSETS, ACR SUPPORTS this bill (House bill passed in 2015/Senate still working on companion legislation in piecemeal fashion). Senate Finance Committee’s “Chronic Care” Initiative. Pending effort by the Senate Finance Committee to review the manner in which Medicare cares for patients with chronic health care conditions. To date, no formal legislation has been introduced. ACR is NEUTRAL on this effort. If Congressional staff asks additional questions related to these bills or any other bill not listed above and you are unsure of the correct answer, please refer them to ACR’s Government Relations office. It’s okay to indicate that you do not know the answer to a specific question unrelated to our primary legislative issues! 16

17. Congressional Packets Cont.  Cheat Sheet-  One page summary of all the key points to make during your Capitol Hill meeting.  Only included in attendee packets and it’s intentionally brief.  Follow the document step-by-step in chronological order.  Do NOT leave the cheat sheet for Congressional staff. The cheat sheet is only for radiologists.  If you only read one document in the attendee packet, READ THIS DOCUMENT! 17

18. Capitol Hill Meeting Feedback Form  After you complete your House and Senate meetings, if your schedule permits, please be sure to fill out feedback forms.  These forms summarize the key portions of the meeting so ACR GR staff can follow-up with the Congressional officers.  Follow-up is crucial to securing cosponsors so please provide detailed feedback.  Be sure to include the full name of person you met with.  If your schedule doesn’t permit you to complete the feedback forms on 5/18, you are able to email or fax the completed form. 18

19. Advocacy? We have an App for that!  App is available in both the Apple and Android platform  Search: Radiology Advocacy  No charge to the end- user to download and/or use  Application features built to meet advocacy needs 19

20. Key Features  Schedule of Events  Talking Points/Issue Pages  Videos  Social Media Integration  Capitol Hill Day Response Form  Live Update Stream via Twitter  State and Federal Congressional Directory 20

21. Mock Good Meeting Starring ACR Players: Rebecca Spangler Chris Sherin 21

22. Questions? Chris Sherin, Director, Congressional Affairs 1∙800∙227∙5463, ext. 3488 Csherin@acr.org 22