Ohio Creates New Office to Look at Health Spending
Ohio Governor John Kasich has signed an executive order creating a new Office of Health Transformation (OHT) aimed at addressing Medicaid spending programs and streamlining delivery of medical services. As federal health reform is implemented, demand for Medicaid services is expected to rise in the coming years. The goal of the new office is to constrain the rate of cost growth by transforming how health providers approach care. In the first six months following its creation, the office will be tasked with:
- Advancing the Medicaid modernization and cost priorities included in the governor's budget;
- Initiating and guiding the planning of a new insurance market exchange;
- Engaging private sector partners to set expectations for overall health system performance; and
- Recommending a permanent structure for health and human services and overseeing transition to that structure.
Together with the state health and human services agencies, OHT will lead the effort to make changes to the state's Medicaid programs and implement cost-containment measures. Additionally, the office will be charged with forming private sector partnerships to improve program efficiency, as well as recommending a new health and human services organization structure for the state.
(Contact: Caryn Marks)
Kansas to Streamline Health Departments
Kansas Governor Sam Brownback plans to eliminate the Kansas Health Policy Authority (KPHA), merging its functions into the Department of Health and Environment to save administrative costs. The KHPA currently administers and coordinates purchasing for the state's Medicaid programs.
The change would allow the governor to more directly steer necessary changes to health care safety net programs. The director of the Department of Health and Environment is appointed by the governor, while the KHPA is supervised by a board that includes gubernatorial appointees, the insurance commissioner the education commissioner and members selected by legislative leaders.
(Contact: Brad Finnegan)
Connecticut Governor Receives Recommendations to Cut Prison Costs
Connecticut Governor Dan Malloy has received the final recommendations from the Policy Working Group on Public Safety to contain prison costs, while maintaining public safety. Specific recommendations from the working group include:
- Reevaluate sentencing practices and drug laws related to nonviolent drug offenders and consider the use of alternative sentencing options, including treatment options;
- Implement a decision‐making body authorized to review and set policy for the state on reentry issues;
- Require the Connecticut Board of Pardons and Paroles to establish release decision‐making policies that incorporate risk and needs assessments and link the terms and conditions of parole to these assessments; and
- Consolidate adult community corrections into a single entity to eliminate redundancies and strengthen continuity of care and custody.
Gov. Malloy created the working group in December, as a part of the Transition Team Policy Committee, to develop policy suggestions.
(Contact: Alisha Powell)
California Proposes Corrections Reforms
California Governor Jerry Brown's proposed budget includes reforms to the prison and parole operations policies to help address the state's ongoing budget crisis. Specifically, the governor's budget proposes the following:
- Place offenders convicted of non-violent, non-serious, non-sex offenses (and without any previous convictions for such offenses) under local jurisdiction, while the state remains responsible for inmates convicted of the most serious offenses. This is expected to save the state approximately $1.4 billion; and
- Eliminate the Division of Juvenile Justice by 2014 and transfer jurisdiction for juvenile offenders to local governments, resulting in an additional estimated savings of $250 million.
(Contact: Jeffrey McLeod)
New Jersey School Buses to Advertise
New Jersey has enacted legislation to allow advertising on the outside of school buses as a way to generate revenue to local school districts. The ads are expected to raise at least $1,000 to $1,500 per bus per year. The legislation stipulates that 50 percent of ad revenue at each school participating in the ad program must be used for fuel to bus students, and the remaining revenue may be used at the discretion of the school board.
The New Jersey Board of Education will establish rules and regulations to govern the size and suitability of the ads, and local school boards would be required to give prior approval for ads before they are reviewed by the state.
(Contact: Lauren Stewart)
Louisiana Proposes Options for Charter School-Business Partnerships
Louisiana Governor Bobby Jindal is pursuing legislation that would pave the way for partnerships between businesses and new charter schools. If passed, the legislation would allow for businesses to:
- Provide facilities or land to a new charter schools;
- Partner with schools to provide or support career counseling, technical education and mentoring; and
- Tailor school missions to align with business needs (i.e. a school may focus on a specialized field such as telecommunications).
In return, the partnering business would have a minority percentage of school board seats and preferred enrollment for employees' children. The governor's proposal is modeled after Florida's "charter schools in the workplace" initiative. The Florida legislation has resulted in five unique partnerships and influenced similar work in 14 additional states.
(Contact: Stephanie Shipton)
Alabama Posts College and University Spending Online
Alabama's public colleges and universities are now required to disclose monthly spending in an online database of state expenditures as part of the state's broader effort to increase transparency and accountability in government.
The database can be accessed by the public at http://www.open.alabama.gov and allows users to search expenditures by amount, date, payer and payee. The government transparency database was launched in 2009 and has grown to include a list of all active statewide contracts and awarded bids, as well as a database of all leases held by state departments.
(Contact: Erin Sparks)
Virginia Releases Comprehensive Transportation Agenda
Virginia Governor Bob McDonnell has announced a series of new transportation proposals for 2011, including the creation of a Virginia Transportation Infrastructure Bank (VTIB) to maximize the effectiveness of state transportation funds. The VTIB will provide low interest loans or grants to localities and private partners to help fund projects not scheduled to be funded in the six-year transportation plan. Governor McDonnell has proposed an initial $400 million in funding for the VTIB, with as much as $1 billion in capital available by the end of his administration. Other legislative or policy proposals regarding transportation from the governor include:
- Granting the commissioner of the Department of Transportation more flexibility to restructure the agency and more authority over certain agency responsibilities;
- A constitutional amendment preventing transfers from the Commonwealth Transportation Fund to the General Fund;
- Providing a tax credit for employers for expenses related to employee telework;
- Dedicating 0.25 percent of sales tax revenue generated in Northern Virginia and the Hampton Roads area to transportation projects in those regions; and
- A $50 per container income tax credit for companies that ship by rail or barge.
These initiatives are part of the governor's $4 billion budget proposal for transportation, which also includes: authorization for $1.1 billion in direct Grant Anticipation Revenue Vehicle (GARVEE) bonds, through which the state borrows against future Federal transportation appropriations; leveraging as much as $6 billion in bonds for public-private partnerships; and nearly 900 specific projects to be funded in the next three years.
(Contact: Andrew Kambour)
Connecticut Proposes Energy Policy Reforms
Connecticut's Policy Working Group on Energy established by Governor Dan Malloy has presented its final report to the governor, including a recommendation that the state create an Energy Policy Office to coordinate statewide energy efforts. The new Energy Policy Office would consolidate the duties of 14 entities in the state that currently have a role in determining energy policy and would be contained within the Department of Public Utility Control (DPUC). Other proposals by the working group include:
- Formally restructuring DPUC and changing its mission to cover broader energy issues, not just regulation of utilities;
- Procuring energy and energy efficiency resources for state buildings through competitive markets and making similar markets available to municipalities;
- Establishing an RFP process for the procurement of renewable energy to ensure that the state renewable portfolio standard is met; and
- Establishing a mechanism, such as a feed-in tariff, to encourage the development of small-scale renewable energy resources not covered by the RFP process.
The Energy Policy Working Group was one of 12 established by Gov. Malloy during his transition to provide short- and long-term ideas for the new administration to consider to improve the function of state government and boost economic recovery. Other policy areas covered by working groups included agriculture, children's services, education, environment, health care, housing, human services, jobs and economic development, public safety, technology and transportation.
(Contact: Andrew Kambour)
Nebraska Governor Proposes Innovation Initiative
Nebraska Governor Dave Heineman recently introduced a package of legislation as part of the state's new Talent and Innovation Initiative, which aims to spur job creation and economic growth through strategies that focus on creating new companies, growing existing businesses and finding in-state job opportunities for college students. Specifically, the package would support business innovation by:
- Offering an Angel Investment Tax Credit to encourage investment in high-tech and other startup enterprises in Nebraska. To qualify for the tax credit, a minimum investment would be $25,000 per year for individuals ($50,000 for investment funds) investing in early-stage companies with fewer than 25 employees, the majority of whom live and work in the state; and
- Creating a Business Innovation Program to provide competitive grants for private sector research at Nebraska institutions, offer technical assistance in new product development and testing and help expand small business and entrepreneur outreach efforts.
The package also includes legislation that targets workforce development through establishing the Nebraska Internship Program, designed to provide job experience at Nebraska companies to students at the state's public colleges and universities. The program would offer state grants worth up to $5,000 to companies that provide internship opportunities to Nebraska students. Participating companies would be required to provide a 100 percent private sector match to the state's investment. Funding for the actions outlined in the proposals would come from a combination of redirected and new funding.
(Contact: Erin Sparks)
Massachusetts Increases Employee Pension Contributions, Closes Loopholes
Massachusetts Governor Deval Patrick has outlined the next phase of state pension reforms that, coupled with other recently enacted changes, are expected to save taxpayers more than $5 billion in pension costs over 30 years by increasing employee contributions and closing loopholes in the current system. The proposals would require nearly all future state employees to contribute more to their pension and would raise the minimum retirement age for all state employees by five years. The five-year increase would ensure that most workers would pay enough into their pension account during their working years to cover an average 94 percent of the amount eventually paid out to them when they retire, up from the current 84 percent. Workers' take-home pay would also rise slightly because the amount they pay into their pensions every year would be trimmed from 9 percent of their annual salary to 8.5 percent.
The reforms would also work to close loopholes in the current system, including:
- Introducing an anti-spiking rule to limit the annual increase in pensionable earnings to no more than 7 percent of the average pensionable earnings over the last two years plus inflation;
- Eliminating double dipping, or the right to receive a pension while receiving compensation for service as an elected official; and
- Increasing scrutiny of legislation benefiting individual employees by requiring such legislation to be accompanied by an actuarial cost estimate, confirmation of the cost analysis from the Public Employees Retirement Commission and a recommendation from the Retirement Board.
(Contact: Lauren Stewart)
Facebook to Host Amber Alerts
The popular social networking service, Facebook, has created new Amber Alert pages for the 50 states and the District of Columbia, Puerto Rico and the U.S. Virgin Islands. Facebook users who sign up for their state's Amber Alert page will receive instant notifications about child abductions and can share the information with their friends. This partnership with the National Center for Missing and Exploited Children provides a platform for state law enforcement agencies to reach millions of people simultaneously.
Created in 2003, Amber Alerts use the Emergency Alert System (EAS) to notify broadcasters and state transportation officials about a recently abducted child. States such as California, New York and Texas have already located hundreds of missing children with the assistance of their Amber Alert Facebook pages.
(Contact: Carmen Ferro)
Human Services Toolkit Available to Help States Identify Funding
A new toolkit offers information to states on human services delivery resources to support low-wage workers who often need additional benefits to reach economic self-sufficiency. Specifically, the toolkit focuses on federal resources that can help states and local providers offer integrated services to low-income workers and reduce the fragmented system individuals often face when trying to obtain work supports and benefits.
The toolkit serves as a one-stop shop for information for state and local service providers, including: an overview of federal funding streams that can support integrated service delivery methods; descriptions of federal funding by grant type; eligible applicants; and the administering federal agency. It also features available resources in the areas of employment and career advancement, financial and asset building services and income enhancements and work supports.
(Contact: Linda Hoffman)
MIT Report Identifies Policies for Increasing Electric Vehicle Use
A summary report of a symposium held by the Massachusetts Institute of Technology Energy Initiative identified several opportunities for achieving significant electrification of the U.S. transportation system. While the report does not represent the consensus of the symposium participants, three policy measures were determined to be necessary for overcoming current market barriers for increasing the use of electric vehicles (EVs):
- Continued or expanded investment in the research & development of key technologies such as batteries, lightweight materials, charging capabilities and manufacturing processes;
- Established regulatory frameworks for EVs, and demonstration of charging and pricing systems; and
- A comprehensive greenhouse gas emissions policy that affects a shift in both transportation fuels and the generation mix in the electricity sector.
The report also states that establishing solid regulatory, charging and pricing models for EVs, and successfully deploying the infrastructure associated with them, is perhaps the most important step to be taken, as it still has the most unresolved issues and will be critical to achieving consumer acceptance of EVs on a larger scale.
(Contact: Andrew Kambour)
Report Examines State Medicaid Enrollment Rules for 2010
Despite difficult budget situations, nearly all states (49) maintained or expanded their Medicaid and Children's Health Insurance Programs (CHIP) eligibility and enrollment rules in 2010, according to an annual 50-state survey released by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU). Specifically, the survey found that 13 states went beyond maintaining coverage to implement targeted eligibility expansions for children, pregnant women and adults in 2010. Additionally, 24 states cover children in families with incomes at least up to 250 percent of the federal poverty level. The median Medicaid eligibility threshold for parents is 64 percent of the federal poverty level.
The survey also found that states are adopting technology to modernize their programs but still have a significant amount of work ahead as they begin to prepare for health reform. Examples include:
- Fourteen states have streamlined administrative processes enrollment and renewal procedures; and
- Twenty-nine states reported using an electronic data matching system to verify citizenship status of applicants for Medicaid and CHIP.
(Contact: Caryn Marks)
Report Finds School Districts Can Reallocate Resources More Effectively
The Center for American Progress recently released a report detailing the results of a year-long study on district returns on educational investments, which found that school districts are capable of boosting student achievement without increasing spending by reallocating resources more efficiently. The report reflects the first-ever attempt to evaluate the productivity of almost every major school district in the country, illustrated by an interactive map of state and local school districts' returns on investment. The project measured the academic achievement a school district produces relative to its educational spending, while controlling for factors outside a district's control, such as cost of living and students in poverty.
The findings indicate that without controls on how additional school dollars are spent, more education spending will not automatically improve student outcomes. In response, the report offers recommends for state policymakers including:
- Reform school management systems to be flexible on inputs and strict on outcomes;
- Increase accountability of school leaders; and
- Improve transparency by collecting and reporting more data.
(Contact: Stephanie Shipton)
Congestion Remains a Problem, Despite Recent Improvements
The 2010 Urban Mobility Report finds that congestion is still a problem in America’s 439 urban areas. Although the economic recession caused a slow in the decline of mobility nationwide, the report’s data indicates that the problem of traffic congestion remains significant and is likely to increase as the economy recovers. Specifically, the report data show that congestion worsened in 2009 compared to 2008; congestion costs are increasing; congestion delays impact residents of big cities and small towns; and it affects people during both peak and off-peak hours. In fact, congestion caused urban Americans to travel 4.8 billion hours more and to purchase an extra 3.9 billion gallons of fuel for a congestion cost of $115 billion during 2009.
The report offers recommendations for urban regions to address congestion problems, emphasizing the need for a mix of complementary solutions. The most effective broad strategy, according to the report, is inclusive of efforts of businesses, manufacturers, commuters and other travelers. Furthermore, there is no rigid prescription for the best way; each region must identify the projects, programs and policies that achieve goals, solve problems and capitalize on opportunities. Key report recommendations to improve mobility include:
- Add capacity in critical corridors;
- Change travel and land use patterns; and
- Maximize use of existing infrastructure.
Traffic data used in the report represent improved state data and new analyses. Data represent anonymously collected traffic speed data from personal trips, commercial delivery vehicle fleets and a range of other agencies and companies and compiles them into an average speed profile for most major roads. The data show conditions for every day of the year and include the effect of weather problems, traffic crashes, special events, holidays, work zones and the other congestion causing (and reducing) elements of today’s traffic problems. The findings are sorted by state and urban area in the report and include best practice solutions.
(Contact: Greg Dierkers)
NGA Center Webcast: The State Role in Combating Identity Theft
The NGA Center will host a webcast on the state role in combating identity theft on January 26, 2011, from 1:00 – 2:30 p.m. The webcast, in partnership with the National Institute of Justice (NIJ), will review the nature and scope of identity theft and address questions such as: What is identity theft and how prevalent is it? How, when, and where does it occur? Who commits it? And, what are challenges to preventing it from happening? The webcast will also explore actions that states can take to improve how they collect, analyze and share information about identity theft, as well as identify effective policy responses states can use to fight it.
If you have questions, please contact Jeff McLeod at 202-624-5311.
(Contact: Jeffrey McLeod)
NGA Center Webcast: Improving Children's Medicaid. SCHIP Care
The NGA Center will host a webcast on improving delivery systems of care for children on January 31, 2011, from 2:00 - 3:30 p.m. EST. The webcast will address Medicaid and CHIP initiatives that improve the quality and delivery of health care for children. The session will offer listeners examples of state efforts and innovation for using medical homes to improve care coordination, developing children's electronic health records and implementing children's quality measures in CHIP. If you have any questions, please contact Caryn Marks at 202-624-5372.
(Contact: Caryn Marks)
NGA Center Releases Updated Maternal and Child Health Data
The NGA Center released the 2010 Maternal and Child Health Update, which presents 2010 data gathered from U.S. states and territories in an annual survey on maternal and child health.
This year's survey reflects the changing environment in states resulting from difficult budget situations and health reform, and it and focuses on initiatives that states have undertaken to improve care management and provide higher quality and more effective care. Key findings include: medical homes programs are increasingly used to coordinate care for children; managed care is the predominant means of delivering Medicaid services to children; and payment reform is becoming a focus for improving care delivery and coordination for children.
(Contact: Caryn Marks)