Dorothy: [00:00:00] Hi, I’m Dorothy Gibbons, CEO and co founder of The Rose. This man wrote the book on how to be an advocate. James Gray influenced so many policy changes. And he’s here today to tell us why our voice and our story is probably the most important weapon we have in the fight against breast cancer.
Let’s Talk About Your Breast. A different kind of podcast presented to you by The Rose. The Breast Center of Excellence and a Texas treasure. You’re going to hear frank discussions about tough topics and you’re going to learn why knowing about your breast could save your life. Join us as we hear another story and we answer those tough questions that you may have.
James Gray serves as a Senior Government Relations Director of Texas for the [00:01:00] American Cancer Society Cancer Action Network.
James: My primary responsibility is to be the lead lobbyist in Texas at the local, state, and federal level. The way I do that is to build relationships with elected officials. And then we use science to kind of drive our legislative agenda.
And there are a lot of issues that we can get involved in, but science has to be there to help us shape our policy. And then put those issues in front of elected officials to see who might be interested in being a lead sponsor for our legislation. And then what we do is we build a campaign. So we work with coalitions. We work with, uh, we do a lot of media advocacy. And we kind of build these kind of multi layered campaigns to support that elected official as they move a piece of legislation to the legislative process.
Dorothy: James taught me everything I know about advocacy, in fact, he’s even dragged me to Austin on a couple of occasions to give testimonies on behalf of The Rose.
James: You and I remember [00:02:00] the days when the Texas legislature had, uh, the Texas Cancer Council, which was funded at about $2 million every two years. Um, so we went from $2 million every two years to $600 million to fund the Cancer Prevention and Resource Institute of Texas, which now puts Texas as the second largest funder of public cancer research in the entire world. Um, and part of that money goes to cancer prevention, um, which certainly supports the work that you’re all doing. But yeah, we have seen, both of us have seen significant change. And, um, it’s really, I think, important to understand that, you know, that all that can go away.
So my job is really focused on making sure that what the state did in 2007 in creating the Cancer Prevention Research Institute of Texas continues to be a priority for the state.
Dorothy: And that is so true, James. We call it CPRIT, but it’s shortened [00:03:00] from the Cancer Prevention Research Institute of Texas. So, it has been such a game changer.
Before CPRIT came into play, we were dependent on the kindness of the generosity of individuals. We had to ask doctors to help us find treatment. We went from serving a seven county area to a 43 county area because of CPRIT’s funding. And they are all about focusing on cancer prevention; all about providing services. CPRIT is something that no other state in the U.S. has.
James: You can’t overstate, um, to your listeners enough that this is a state agency. Um, this is a state agency, which means the state legislature created this because they understood how important it was for them to play a leadership role in fighting cancer. And not just through research, not just through prevention, not just through education, but kind of a, a multi layered strategy to fight cancer in the state of Texas.
And the, you know, the impact has [00:04:00] been significant.
Dorothy: Because of CPRIT, The Rose is able to serve 1,500 women a year. And that service includes mammograms and ultrasounds and biopsies, all the things that women need to figure out if they really are dealing with breast cancer.
James, what are some of the biggest challenges that the state of Texas faces, especially when it comes to health care?
James: Well, uh, there’s some obvious ones, like, you know, for example, we haven’t expanded Medicaid, and we know that has the potential to impact a lot of vulnerable members of our, our state, citizens of our state, um, and, you know, states that have seen Medicaid expansion have seen a significant improvement and, um, reaching individuals and underserved communities that traditionally wouldn’t have insurance, um, and getting into Medicaid and making sure they’re getting the public health support they need. But more importantly, the screenings for cancer that will save their lives. And that’s the biggest challenge. But you know, there are a lot of other challenges to, you know, [00:05:00] we work on, you know, probably 100 bills every single legislative session that range from: What is the role of, of, of insurance in our state to how do we treat and, and address the challenges that tobacco creates?
Dorothy: Most folks don’t know that Texas has the highest rate of uninsured people of any state in the United States. This is one of the reasons why it’s so important, especially in the areas that we serve, Houston and the Eastern area of Texas. It’s so important to allow us to be able to reach those people.
Some of those areas are dealing with a lot of unemployment, a lot of non- insured people, and it’s a big financial burden for anyone to try and carry their own insurance if you’re not working and don’t have the financial means to pay for it. James has just given us a key component to getting uninsured Texans access to critical health care, and that’s called [00:06:00] You, the Voter.
James: The agency was set up by the legislature. But then the legislature said to voters, you need to authorize the funds to fund this agency. So in 2007, um, they put a constitutional amendment on the ballot that approved, asked voters to approve 3 billion in funding. It passed with 64 percent of the votes. So it was one of the first times that’s ever happened.
It was really kind of an interesting campaign to be a part of, but more importantly, it just showed with that strong a vote in Texas. how important fighting cancer is to Texas voters. And so all of that I think is really great. And then what happened is the legislature asked the voters again to authorize another three billion and that vote happened in 2019.
And, uh, 64 plus percent of the voters came out and, and supported it. And November ballot, when really the only things on the ballot were constitutional amendments.
Dorothy: James, how [00:07:00] well did Texas voters perform?
James: Voters should be proud of what they’ve done. The legislature should be very proud of what they’ve done.
Um, we just, um, you know, Dorothy, uh, in a timely manner, the finance committee met and approved the preliminary ask by CPRIT to fully fund it for the next two years. So that’d be another 600 million for the next two years. Now the budget still gets to go through a lot of different votes before it gets to the governor’s desk.
Um, but I think there’s really a clear understanding about the legislature. They did this, and they are proud of what they’ve done, and they see the, um, impact that this program is having. So, it’s, um, it’s, it’s been a fun project to be a part of, uh, but more importantly, it’s been a rewarding part, project to be a part of.
And Dorothy, I can tell stories about, you know, the work you’ve done on, on CPRIT, but, um, one of the most important things we can do to make sure it gets funded, Is to continue to tell that story of what the impact CPRIT is having. And you’ve done that and you’ve done that in the legislature really [00:08:00] effectively.
So we appreciate that.
Dorothy: Thank you, James. It is always such an honor to be with you and to hear your thoughts. I’m going to share that sometimes being an advocate can be a little intimidating. You don’t know the right words and you don’t think your story is that important. And when you’re talking to your volunteers, how do you prepare them to go and be an advocate and really talk about what’s on their mind?
James: Yeah, that’s such an important question, because I would encourage everybody that’s listening to figure out how, what they’re passionate about, particularly in the cancer space, and use that passion to influence policy. So it’s important to remember, and we share this with our volunteers and our advocates all the time, that you are talking to people in the legislature— whether it’s a member of the staff that have been affected by cancer. Um, I, you know, just for example, I went into an office the other day and two young staffers, I was there talking about a colorectal [00:09:00] issue. Two young staffers, younger than 30, um, said they get colonoscopies on an annual basis because of colorectal cancer in their family.
And so it’s really important to realize that you are talking to folks that have a similar journey to you. have family experiences that, uh, like yours. Um, but more importantly, legislators and staff are there to do the right thing. Um, and, um, particularly in the cancer space, they want to get it right and they want to know what an issue means to them, uh, and their district.
So having somebody come in that can share a personal story is sometimes more effective than someone that can come in and talk about the science around cancer and kind of the innovation that’s happening in cancer. So what we try to do is, is, is just help advocates understand what their story is. And being able to tell that story in about 90 seconds is really important.
And once you do that, you become a very powerful [00:10:00] advocate because you have a personal connection to the issue, which allows you to develop a personal relationship with that, that elected official, that staff member.
Dorothy: Once you make that personal connection, even during the time that there’s not a session going on, you’re To know your local representative is so important.
In fact, it was James experience of losing a loved one to cancer that charted his path to the work he’s doing in the cancer community.
James: I lost my dad to tobacco when I was 25 and I didn’t really understand, you know, what you could do to shape public policy to impact tobacco and youth consumption. But started to learn more about the American Cancer Society through the volunteer work I was doing, uh, through Relay for Life, which is one of their fundraising events.
And, um, a job opened up and I sat and just did a kind of informational interview on, uh, with the hiring manager and begin to realize that [00:11:00] the, you know, the, The sadness I felt and the loss that I felt about my father, I could do something with that. I had a skill set that I could actually use to maybe keep his spirit alive if you would.
And so really kind of went into this work as a tobacco control advocate. Um, and really trying to figure out what we could do to drive down youth consumption of tobacco and, and really kind of marginalized the role that that big tobacco has. And this was right about the time of the tobacco settlement in 1998.
Uh, so it was a really kind of historic time to be involved and a lot of legislation came forward that we could support and had some real progress on, on doing that. And, you know, in 1998, And significant increase of a tobacco tax just wasn’t heard of. Well, Texas has done that. In 1998, making communities smoke free was unheard of.
Well, you know what? Most of Texas has done that. And 1998, raising the age from 18 to 21. [00:12:00] was unheard of, right? Uh, well, Texas has done that and all the stuff that we dreamed of has now happened. But we also have this new challenge with these cigarettes and we’re trying to figure how to, you know, marginalize the impact that these cigarettes are having, particularly on our, our youth.
Dorothy: Every time I listen to you talk or any of the advocates, I think there’s so much that needs to be done. But there’s also so much we can do. I just want to reiterate about that part of being a voter and knowing the issues and also not being afraid to tell your story. I think that’s been the magic of the American Cancer Society, that it’s brought people together, it’s helped them tell their stories.
You know, decisions are not always top down. It was really your neighbor or your cousin or someone you knew going to Austin and talking about how important some of these bills were.
James: And listening to them too, what are their priorities? And how can we help them on, you know, with their own priorities? So, you know, it is [00:13:00] definitely a relationship building process and our volunteers, we’ve got, we’ve, we have volunteers that have been doing this for 40 years that know their legislators so well, they can pick up the phone and, and, and get to that individual in a way that I can’t walking the halls of, of the Texas Capitol.
And that’s powerful for the work that we do.
Dorothy: So when we hear folks say that their vote doesn’t count, I think you’ve given us about 10 different examples of how much it did count. And just moving forward with CPRIT was huge. I know when I go to other states, and they talk about, oh, they don’t have anything that’ll help the uninsured.
You know, but Texas, Texas has something and it’s called CPRIT and that’s been a game changer.
James: There’s a lot of different ways to look at the investment that the legislature’s made in CPRIT, right? But, but it really is building this biomedical infrastructure. And so bringing in, um, you know, these, these well known researchers from around the [00:14:00] world to Texas is building out this kind of research hub, recruiting, recruiting businesses to Texas that, that do product development and drug development is really critical to the state of Texas.
So, it really is building an infrastructure that just didn’t exist, you know, 15 years ago. Um, and we are lucky now in Texas to have access to this infrastructure that, um, not just, not just benefits us, but it benefits the world.
Dorothy: I sure am grateful though that they are focusing on cancer because we’ve seen a big change in that area.
James, you talked a little bit about it was fun to be part of the 1998 campaign. When you end the day, what do you call a fun day?
James: A fun day is when you get— You either volunteer to understand how important they are in this process, or you get an elected official to understand what you’re saying, and why it’s so important to their constituents.
And that doesn’t happen every day, right? I mean, there’s some hard days, because when you don’t win, and when you lose in this work, you, [00:15:00] you can, it’s very painful, right? There’s some things, we have a big hearing on Wednesday. That would allow for, um, coverage of biomarker testing for Texans through their state regulated insurance and also for Medicaid recipients.
Um, that’s a really important bill because it’s about precision medicine. Um, and we need protections through state law. But if you don’t get it passed, you know, there’ll be some folks that won’t benefit from biomarker testing and biomarker testing is really where we’re going in the treatment of this disease, the treatment of cancer.
So, um, trying to be positive. Um, I would say it really is about shaping the discussion through a volunteer’s voice that understands the role they play and more importantly, how they can shape the change. And seeing that change or that elected official get affected by that, that work, the volunteers done it’s, it’s that grassroots work that will, um, have the ability to sustain change over a long period of time.
So one vote on one [00:16:00] bill, you certainly feel good about, but there’s always something more to worry about when you have a vote and that is, how’s the next vote going to go? Is the bill going to get voted on by the governor? or, or, you know, signed by the governor. Once it’s passed, you have to worry about getting the rules written to make sure the law actually is, is putting the practice the way you intend it to be practiced. Right? Um, so a good day for me is really that, that relationship between me and the volunteer, the volunteer and the member and getting distance. Getting to kind of witness the effect that that has on the work that we do.
Dorothy: Because of his work, James has inspired people across the Lone Star State to join in the fight against cancer.
And that includes his daughters.
James: We do fundraising events, they’re part of that, primarily so they kind of know why we work long hours and do what we do, right? But yes, it’s been interesting. My daughter went to her first bill signing in 2011. It was a bill I worked on, but I took her just to give her that exposure.
And she [00:17:00] got probably 15 minutes with governor Perry at the time. And she became an advocate, um, on an issue that’s important to her. That’s now become a legislative priority, um, in the, in the state legislature with leadership. It’s the, um, the menstrual tax. And that’s now being something that’s being promoted by the governor and speaker and, um, and testified on the bill last session and really understands kind of the power of public policy now.
And it’s really kind of exciting to kind of see or take that on. My other two are expressing an interest in it. Um, they’re right in the middle of high school right now. So it’s a little bit of a challenge. Um, I’ve got my youngest, I think is probably cut out of a lobbyist cloth. Uh, I think if she ever moved in this direction would probably thrive as a lobbyist, um, depending on the issue.
But, uh, it’s been fun to kind of, uh, expose them to this. And then more importantly, watch them kind of shape their own actions.
Dorothy: What a great [00:18:00] experience for your oldest one. And for her to be involved right now, that’s incredible. I guess that’s really another message to our listeners. You can’t start too young.
People know what they’re passionate about. They know what really resonates in their soul. And when it does, they need to go after it.
James: It’s really easy for youth to be advocates right now. Um, I mean, the pandemic shaped the virtual opportunities in a way that opens up a lot of advocacy avenues for, for young people.
So I think it’s really exciting to kind of see my kids find some of this stuff and then more importantly kind of jump in and try to figure out how they can use it to their advantage. So, um, there are a lot of opportunities for young advocates that didn’t exist 40 years ago.
Dorothy: And if that’s not inspiring enough, James wrapped up our conversation with one of the most inspiring stories you’ll hear all day.
James: We were working on a bill in 2011. So chemotherapy was moving more to an oral format. Right. So we’re seeing more and more chemotherapy [00:19:00] drugs come on, not as intravenous, but as oral equivalents. And so basically the insurance companies were treating them as a pharmacy benefit, which was really expensive for, um, for Cancer patients and we said no they needed to be treated like intravenous chemotherapy So we build a campaign around this issue and work with elected officials and weren’t getting anywhere in this one committee And so we found a woman that owns a salon in a community in Central, Texas who had a very real oral chemo story to tell and She went before the committee meeting and told the story And basically, you know, the, the committee chair gaveled out like, you know, this isn’t going to happen, you know, and this committee chair was notorious for not letting bills like this pass.
Well, within five minutes, um, the chief of staff of this committee member, of this committee chairman came down and said, [00:20:00] Oh my God, Chrissy, is that you? I haven’t seen you since high school. I didn’t know your story. I can promise you this bill will be out of committee tomorrow. So what was a no became a yes because of the personal connection that this woman didn’t even know she had, but she wouldn’t have known she had it unless she went in and told her story.
With the chief of staff of this particular office, and he understood why it was so important as soon as he saw her. And as soon as you heard that story, I can’t do that as a lobbyist, but you can, as, as patients, as survivors, as caregivers, Because you know the journey that you’ve been on and that journey needs to be shared because it can shape the outcome of our legislative agenda in a really positive way.
Dorothy: Wow, that is such a great story. I really appreciate everything you’ve shared with us. We need more of those in this world and appreciate you for the commitment. James, thank you for being our advocate. It means so much to the women [00:21:00] that we’re trying to take care of.
James: Well, Dorothy, thank you. And I have a lot of Dorothy stories to tell about the work that you’ve done to shape public policy.
So we’ll save that for another time, but thank you for having me on.
Post-Credits: Thank you for joining us today on Let’s Talk About Your Breasts. This podcast is brought to you by The Rose. Visit therose.org to learn more about our organization. Subscribe to our podcast, share episodes with friends, and join the conversation on social media using #Let’sTalkAboutYourBreasts.
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