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Reducing the Burden of Injury: Advancing Prevention and Treatment
These important activities—public education, constituency building, and advocacy—must be carried on with due regard for long-standing legal constraints on ''lobbying," which are designed to limit contact with legislators, directly or through grassroots efforts concerning specific legislative proposals. Federal grantees may not use federal funds for lobbying, and nonprofit organizations lose their tax-exempt status if they devote too much of their activities to lobbying. However, these restrictions on lobbying still leave the organizations free to engage in a wide range of educational activities. Unfortunately, many organizations in the injury field appear to be unsure about the boundaries between advocacy and lobbying and thus are uncertain about the legitimate scope of educational and constituency-building efforts. Nonprofit organizations in the injury field should understand the federal and state rules that govern lobbying. By better understanding these rules, nonprofit organizations can maximize their effectiveness as advocates for the public's health, while minimizing the likelihood that they will jeopardize their nonprofit legal status.
The federal government itself has recognized that changes in state and local policy are often necessary to help effectuate national public health policy goals. Many Healthy People 2000 goals focus on state legislative action (U.S. DHHS, 1990). Congress often makes state eligibility for federal program support conditional upon state legislative action (e.g., the 21-year-old minimum drinking age). In many situations, however, Congress is not so directive, relying instead on public education and local constituency building to arouse public support and eventually achieve state and local legislative action. It is well understood that nonprofit organizations interested in public health issues devote substantial resources to public education and issue advocacy, even though their lobbying for a specific piece of legislation is restricted.
Thus, advocacy for national public health objectives by federal grantees and nonprofit organizations is often encouraged by federal policy. Against this background, the committee believes that recent proposals to curtail advocacy by federal grantees and nonprofit organizations are troubling. For example, proposals have been made to preclude federal grants to organizations that spend more than a specified amount on "political advocacy," thereby broadening the constraints and compelling the use of nonfederal funds by these organizations (Moody, 1996). In the committee's view, the achievement of national public health priorities, including injury prevention objectives, would be significantly impeded if Congress were to broaden traditional constraints on lobbying by federal grantees and nonprofit organizations beyond their long-accepted meanings and boundaries to include advocacy. Traditional restrictions adequately carry out the federal government's legitimate interest in avoiding taxpayer-subsidized political activity and the distortion of the political process to which subsidized political activity might lead. More sweeping restrictions on the advocacy of ideas or positions not only would have a chilling effect on constitutionally protected activities by federal grantees and tax-exempt organizations, but would also undermine the U.S. government's strong interest in promoting public