Hartford Business Journal

HARTFORDBUSINESS.COM | DECEMBER 9, 2024 11 seventh in 2021-22 ($856,989), but has fallen to 13th so far in 2023-24 ($584,986), according to state data. The nearly 32% drop off in spending in the current reporting cycle is because YNHHS rebid its contract for an outside lobbying firm, which reduced costs, Mounds said. "It's not just about paying people directly. That's usually for the lobbying firms," he said of the spending amount. Internal health system staff must track the amount of time spent doing lobbying-related work, because that also applies. "If we create documents or other resources, that counts towards the lobbying number," Mounds said. "If we register additional senior-level leadership as lobbyists based upon issues that come up, that plays a part in the number." Indeed, some of the state's top healthcare executives are registered as lobbyists. That includes Yale New Haven Health CEO Christopher O'Connor, Hartford HealthCare CEO Jeff Flaks, Bristol Health CEO Kurt Barwis and Nuvance Health CEO John Murphy, among others, ethics data shows. Buckley said the spending figure also accounts for subject-matter experts who address legislative committees to educate policymakers on an issue. "I think when people read (the numbers), they're only thinking someone is getting in the hall and saying, 'please vote this way.' In Connecticut, lobbying entails so much more," she said. While YNHHS has reduced its lobbying spending, Hartford Health- Care went in the opposite direction. The organization's spending jumped from outside the top 20 in 2019-20 to third overall in 2023-24. While no one from Hartford Health- Care would agree to an interview about its lobbying efforts, the health system provided a statement via email. "Over the last several years, Hartford HealthCare has been laser focused on transparency — reporting year-round, as opposed to only when the legislature is in session," the statement said. "We follow ethics guidelines meticulously, which may explain the changes in reporting — though not a change in spending." HHC declined to expand further on that statement, but added: "We engage with lobbyists and lobbying firms to ensure that our lawmakers have the most current and accurate information on the issues impacting healthcare delivery and public health in our state." The issues CHA's Buckley said the issues that concern her members can vary with each legislative session, but there also are common threads. In addition to representing 27 acute-care hospitals in the state, the CHA's members also include psychi- atric hospitals, rehabilitation centers, nursing homes, infirmaries and clinics, among other organizations. "We may have different specifics for individual organizations, but we all have very common elements that transcend each individual organiza- tion — advocating for patient access, for health equity," and on the state's regulatory processes. One key annual issue is the state's Medicaid reimbursement rates, which hospitals and other providers have long complained are inadequate and contribute to financial strains and industry consolidation. On the regulatory front, there were four major bills proposed last year to reform the state's certificate of need process, which regulates certain healthcare mergers, acquisitions, equipment purchases and other business transactions. All four proposals failed to pass, but the issue is expected to come up again next session. Hospitals have complained the business-transac- tions approval process is burden- some and takes too long. Buckley also cited access to behav- ioral health and workforce issues, such as the shortage of nurses, respiratory therapists and medical technologists. "We need to work with the state to make some kind of investment in that, because any changes to the workforce won't happen overnight," Buckley said. Halpin said the health plans asso- ciation also advocates on several general business issues, "everything from cybersecurity to the artificial intelligence bills." She added that much of the focus is on defending against legislation health insurers believe will do more harm than good. "The vast majority of bills that we're following or are engaged in, I would say, (involve) either playing defense or shaping them so that they take into account the practical impact of those pieces of legislation," Halpin said. Specifically, she said, CTAHP closely tracks bills that require new coverage benefits because while they may be well-intentioned, they can often result in "higher costs, higher premiums and higher expenses for the consumer." Halpin added that it can sometimes be hard to know what unexpected issue may arise during a legislative session. "There's always kind of surprise issues that emerge and, as such, we have to monitor and digest all kinds of different proposals," she said. "So, we're watching everything closely and we'll continue to do that." TOP 10 ISSUES LOBBIED ON IN CT (2023-24) RANK ISSUE NO. OF ORGANIZATIONS PAYING FOR LOBBYING SERVICES 1 Government–financing, taxation, revenue, budget, etc. 279 2 Health and hospitals 272 3 Human services 210 4 Environment 187 5 Economic and community development 183 6 Education 179 7 Business 160 8 Insurance–medical. dental, mental health 154 9 Energy 153 10 Transportation 153 Source: CT Office of State Ethics 'Not a dirty word': State Ethics Office tracks lobbyists; $34.8M spent in 2024 as of mid-Nov. By David Krechevsky davidk@hartfordbusiness.com I f you ask Pete Lewandowski, executive director of the Office of State Ethics in Hartford, he'll tell you that lobbying is not "a dirty word." "We're trying to break that stereotype out there," Lewand- owski said during a recent interview with Hartford Business Journal. "Lobbying is a constitu- tionally protected form of speech." In fact, it's among the freedoms cited in the First Amendment of the U.S. Constitution. Along with the freedom of religion, speech, the press and to peaceably assemble, it guarantees the right to "petition the government for a redress of grievances." That petitioning can take a few different forms; lobbying is one of them. Of course, like anything else, there are bad actors who try to abuse the system. That's where the state ethics office comes in. Among other things, the office's 16-person staff regulates and enforces the rules on the people and organizations that register each year to lobby state legislators and agencies. It also conducts audits and imposes penalties on those who fail to comply. "Our role is simply to provide transparency to the process," Lewandowski said. The parameters Under state law, anyone who spends $3,000 or more on lobbying must register and file regular financial reports. That $3,000 threshold covers a broad range of things an individual or organization can spend money on as they attempt to inform and/or influence elected and appointed officials. "The bulk of these expenditures are related to … payments to lobby- ists to spend endless hours at the Capitol to monitor legislation and so on," Lewandowski said. It also includes costs related to hiring subject-matter experts to testify before a committee, including not only an expert's fee but the cost of transportation, room and board, he said. The state also tracks spending on marketing and advertising, including the cost of entertaining legislators or state officials. "If a lobbyist holds a legislative reception at the Capitol during the session, those costs have to be reported," Lewandowski said. There are exceptions to the regulations on who must register as a lobbyist. An example is the "five- hour rule," which allows corporate executives to meet with public officials or legislators to discuss an issue for up to five hours before the lobbying registration rule kicks in. The rules don't apply to municipal officials who meet with legislators or public officials as part of their job. The numbers There are penalties for failing to comply with the rules, including a $10,000 fine for each violation. Depending on the nature of the violation, criminal charges are also possible. There is also the poten- tial to be barred from lobbying for two years. The ethics office released a report on Nov. 19 stating that, based on its current lobbyist registrations, "there are 1,131 registered client lobbyists (people hired to lobby on behalf of others), 560 in-house communicators (lobbyists directly employed by an organization) and 193 individual communicators." In addition, based on disclosure statements, $34.8 million was spent on lobbying from January through mid-November 2024. Of that total, $33.1 million was direct compensa- tion for lobbyists, it said. Lewandowski, who served as a staff attorney in the compliance division before being named executive director in August 2019, says lobbyists generally comply with the rules "Lobbying is a reputational activity," he said. "If you sully your reputation, guess what, … your clients will go away from you." Office of State Ethics Executive Director Pete Lewandowski. CONTRIBUTED PHOTO

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