State News
Florida Urgent Care Centers to Post the Prices of Common Services
Florida Governor Rick Scott signed legislation that will require urgent care centers to prominently display the costs of their 50 most frequently provided medical services, which will help patients who pay out-of-pocket for health care compare prices. The posting must be in a conspicuous place in the reception area and be at least 15 square feet in size.

Primary care providers—defined as advanced registered nurse practitioners, physician assistants, and family/internal medicine physicians—are also encouraged to display this information. Those who do so will receive a one period exemption from the professional license renewal fee and two-year exemption from continuing education requirements.
(Contact: Jason Hsieh)

Kentucky Expands Medicaid Managed Care
Kentucky Governor Steven Beshear expanded the state's Medicaid managed care program and expects to save taxpayers $375 million in General Funds and $1.3 billion in all funds over the course of new three-year contracts. Contracts were awarded based on a request for proposal that emphasized a holistic approach to health care, improvement to the quality of care, and reducation of costs. Specifically, the goals of the contracts are to improve health care outcomes, reduce the inappropriate and unnecessary use of services, improve care coordination, and to lower the overall cost of health care.

Additionally, a newly created Medicaid Managed Care Oversight Branch will enforce contractual provisions and ensure services are delivered accordingly. Administrative guidelines are built into the contracts to ensure taxpayer dollars are spent effectively and consumers have adequate protections. The health plans will also be required to submit monthly, quarterly, and annual reports to the Department for Medicaid Services to assure quality, access to care, cost effectiveness of services and to evaluate contractual performance and utilization of services by Medicaid members.
(Contact: Kathryn Bailey)

Wisconsin Announces Collaborative Effort to Redesign School Accountability
Wisconsin Governor Scott Walker announced  a collaborative statewide initiative to develop a new accountability system for public schools that takes into account student growth and multiple measures of student performance. Data collected as part of the new system will also be used to identify and replicate best practices. The effort is led by the governor and the superintendent with participation from legislators and representatives from small business, teacher unions, parent groups, charter schools, higher education, superintendents, and school leaders. Groups will participate in panel sessions throughout the summer and fall to identify key components and policy needs for establishing and implementing the new accountability system alongside state efforts to raise academic standards, develop high quality assessments, improve data systems, and support early reading.

Designers plan to draw from the accountability design principles highlighted in the Council of Chief State School Officers' "Roadmap for Next Generation Accountability."
(Contact: Stephanie Shipton)

Michigan Reorganizes Education Agencies
Michigan Governor Rick Snyder used an executive order to consolidate the state's early childhood programs into the newly created Michigan Office of Great Start. The new office is charged with overseeing the more than 80 funding sources across multiple agencies that support early childhood education. In total, three offices will be combined, which is expected to result in a reduction of duplications and costs for administration and overhead.
(Contact: Stephanie Shipton)

Hawaii to Explore New Financing for Energy Efficiency
Hawaii Governor Neil Abercrombie has signed a bill to help explore an alternative financing method for making energy efficiency improvements to existing homes. The new law directs the Public Utilities Commission (PUC) to study the creation of an on-bill financing program in the state and the discretion to implement. On-bill financing allows residents to receive a loan for the up-front cost of energy efficiency improvements or renewable energy systems, and then pay back the cost over time through their electricity bill, with the monthly payment roughly equal to the projected energy savings. Governor Abercrombie initially intended to veto the bill since it did not include additional revenues to fund the study, but a consortium of private companies has offered to partner with the PUC to help cover the costs of the study, prompting the governor to sign the bill.
(Contact: Andrew Kambour)

Illinois Encourages Electric Vehicle Purchases
Illinois Governor Pat Quinn has signed two bills designed to expand the use of electric vehicles (EVs) in the state. The first bill creates a new grant program for car-sharing companies to help them purchase EVs for use in their fleets. Eligible companies can receive grants worth up to 25 percent of the cost of vehicle purchases. The EVs must be registered in Illinois and remain registered in the state for five years following the purchase. The grants will be administered by the Illinois Environmental Protection Agency and will be funded by the existing Alternate Fuels Fund, which currently provides rebates to vehicle owners to help cover the purchase or conversion costs of EVs or ethanol-fueled vehicles. Capital for the Alternate Fuels Fund comes from registration fees currently charged to private vehicle fleets; electric vehicles are exempt from paying these fees.

The second bill establishes a new Illinois Electric Vehicle Advisory Council, which will recommend strategies for encouraging the use of EVs and promote the EV industry in the state. Members of the advisory council will be selected by the governor and will serve on a volunteer basis.
(Contact: Andrew Kambour)

Louisiana Adopts Probation and Parole Reforms
Louisiana Governor Bobby Jindal has signed several new bills into law designed to enhance the state's pardon and parole process, improve tracking of offenders sentenced to home incarceration or electronic monitoring, change parole eligibility criteria for nonviolent offenders and reduce offender recidivism. For example, the package establishes a validated risk and needs assessment tool to inform parole board supervision and treatment decisions. The legislation also allows probation and parole officers to punish probationers and parolees with administrative sanctions for technical violations of supervision conditions.

Other specifics included in the new bills are:

  • House Bill 416 provides earlier parole eligibility for first-time nonviolent, nonsex, nonhabitual offenders.  Under the bill, qualified offenders will become parole eligible after serving 25 percent of their sentence.  The state will reinvest anticipated cost savings from the legislation into evidence-based programs and probation and parole supervision;
  • House Bill 106 creates reporting requirements for providers of home incarceration and electronic monitoring services so that courts, police, and the Department of Corrections can better track how many offenders have been sentenced to home incarceration or electronic monitoring and determine how successful the supervision has been; and
  • Senate Bill 202 requires members of the Pardon and Parole Board to complete immediate training upon appointment, plus eight hours of annual training, in an effort to ensure board members are equipped with the tools necessary to make informed parole decisions.

Louisiana participated in the NGA Center Cross Governmental Sentencing and Corrections Policy Forum, which helped states identify and evaluate strategies to enhance state sentencing and corrections policies that will reduce corrections costs and improve sentencing outcomes.
(Contact: Jeff McLeod)

Rhode Island Creates Cyber Disruption Plan and Response Teams
Rhode Island has introduced a new component of the state's emergency management approach to include cyber disruptions. The cyber annex to the state's emergency management plan addresses the state's response to cyber disruptions caused by natural hazard, widespread virus or cyber-attack to ensure continuity of service. The plan also calls for the creation of a cyber disruption response team, among the first in the nation dedicated to restoring cyber communications as a result of a natural disaster or man-made disruption of service. The multi-disciplinary team includes the state emergency management agency, state police, and stakeholders from higher education, hospitals, defense, utilities and the financial services sector.

The cyber disruption annex effort was developed by the Rhode Island Emergency Management Agency, in collaboration with the state police, the Rhode Island National Guard, internet service providers and utility companies.
(Contact: David Henry)

Maryland Streamlines Permit Review Process
Maryland Governor Martin O'Malley signed an executive order to streamline and expedite the review of state permits for projects in priority development areas. Under the FastTrack initiative state agencies will work concurrently to review projects. This will speed up business investment and productivity. The governor's Smart Growth Coordinating Council will work with eligible companies by identifying necessary state agencies and permits and guiding projects through the licensing and regulatory process. The FastTrack process can be used in priority development areas including:

  • Designated Main Street areas;
  • Transit-oriented development zones;
  • Arts and entertainment districts; and
  • Enterprise zones.

The Maryland Made Easy website provides an interactive map showing the locations of priority development areas.
(Contact: Erin Sparks)

Illinois Reforms Workers' Compensation System
Illinois Governor Pat Quinn signed legislation to reform the workers' compensation system, which is expected to save employers between $500 million and $750 million. The bill includes the following reforms:

  • Reduces medical provider rates by 30 percent;
  • Requires the use of American Medical Association standards to determine impairment and disability;
  • Creates workers' compensation provider networks to ensure that employees receive cost-effective treatment;
  • Enhances enforcement against employers who fail to maintain workers' compensation coverage; and
  • Establishes an electronic billing process from providers, protecting workers from treatment disruption.

The bill also reforms the Workers' Compensation Commission by establishing three-year terms for arbitrators, and requiring arbitrators to be licensed attorneys and follow ethics rules.
(Contact: Garrett Groves)

Other News
Survey: 90 Percent of Businesses Experience Cyber Security Breach
A survey of IT and IT security professionals finds that 90 percent of businesses were victims of a cyber security breach at least once in the past 12 months, demonstrating that businesses of all types and sizes are vulnerable to attacks. The survey also found that organizations are experiencing more multiple breaches with 59 percent of respondents citing two or more in the past 12 months. Overall, companies indicated that addressing security breaches have cost them at least half a million dollars in terms of business disruption, revenue losses, internal labor, overhead and other expenses. Additional findings from the survey include:

  • Only 11 percent of respondents knew the source of a network security breach;
  • 48 percent of respondents cite complexity as one of their major challenges to implementing network security solutions—the same percentage stated that resource constraints was their biggest challenge;
  • Employee mobile devices and laptops are the most likely source of cyber-attacks; and
  • 76 percent of respondents stated that cyber-attacks can be combatted by streamlining or simplifying network security operations

(Contact: Alisha Powell)

Renewable Energy Reaches Production Milestone
Data from the latest U.S. Energy Information Administration Monthly Energy Review shows that energy production—for electricity, transportation, and thermal energy—from renewable sources reached 2.245 quadrillion British thermal units (BTUs) in the first quarter of 2011. This compromises nearly 12 percent of US energy production and surpassing energy generated by nuclear power, which provided 2.125 quadrillion BTUs, for the first time. Renewable energy production was 15 percent greater in the first quarter of 2011 than the first quarter of 2010 and 25 percent greater compared to the same quarter in 2009. Renewable electricity output grew by nearly 26 percent compared to 2010, including a 105 percent increase in solar electric output and a 40.3 percent increase in wind production. Renewable sources now make up nearly 13 percent of U.S. electricity output, up from 10.3 percent at this time last year.
(Contact: Andrew Kambour)

Report Examines Future of American Workforce
A new report from the McKinsey Global Institute outlines strategies to create new jobs and revitalize the American workforce following the recession. An Economy that Works: Job Creation and America's Future finds that 21 million new jobs will need to be created by 2020 to put unemployed Americans back to work and keep pace with the growing population. Six sectors have the potential to create many of the needed new jobs in the next decade: healthcare, business services, leisure and hospitality, construction, manufacturing and retail. These sectors account for 66% of jobs today and are projected to represent 85% of new jobs created by 2020. The report finds that many workers will not possess the appropriate education and skills to fill new jobs in the next decade; it suggests closing these skills gaps by expanding vocational and community college opportunities and establishing credentialing systems. Finally, the report forecasts that employers will increase the flexibility of their workforce by utilizing advances in technology and communications. These strategies will include hiring part-time, temporary and contract workers; telecommuting; outsourcing; and offshoring.
(Contact: Erin Sparks)

Survey: Non Degree-Holders Perceive Barriers to Higher Education
Public Agenda recently conducted a survey to examine the attitudes of American youth towards education and prosperity. According to the findings, young people without a college degree are more likely to be pessimistic about their future than their peers with a college degree.  However, young people without a college degree tend to believe there are ways to succeed without furthering their education, are less likely to be open to borrowing money for college, are less trusting of the motives of institutions of higher education, and tend to have educational gaps that may undercut their ability to attain a college degree should they choose to enroll in an institution of higher education. The report suggests that counselors and college administrators look for ways to strengthen outreach to lower-income students, many of whom may not realize that they can attend college by going part-time and taking out federal student loans.
(Contact: Stephanie Shipton)

Implementing Health Homes in Medicaid Managed Care
The Center for Health Care Strategies released an issue brief exploring how states might implement health homes as part of their existing Medicaid risk-based managed care organization (MCO) infrastructures. It outlines advantages and challenges MCOs may face in developing health homes and factors states should consider in deciding how to proceed. Under the Affordable Care Act, health homes must provide comprehensive care management, care coordination, health promotion, comprehensive transitional care and follow-up, patient and family support, and referral to community and social support services. Evidence suggests that care management services, particularly those provided at point of care, improve quality and reduce cost and avoidable emergency room visits and hospitalizations.

Health homes present a way for MCOs to redefine their role and confirm their values, while curbing health care costs. Some of the key issues that MCOs will need to consider in their expansion include:

  • Assessing their current coverage, in terms of demographics and services, to see what expansion may encompass;
  • Examining what home health services that the MCO currently offers and how they will contract out for the missing services;
  • Investigating reimbursement structures for the home health services, especially if the MCO does not act as the health home in its totality; and
  • Evaluating quality, cost and utilization outcomes to ensure the effectiveness of health homes.

(Contact: Jason Hsieh)

What's New
NGA Holds 2011 Annual Meeting in Salt Lake City, Utah
The NGA is holding its 2011 Annual Meeting July 15-17 in Salt Lake City, Utah. Over 30 governors and their staff will convene to discuss issues affecting states, including a special stand-alone session of the Economic Development and Commerce Committee where a discussion about international trade and investment's role in domestic economic growth and job creation will take place. Following the session, governors will meet with members of their respective standing committees: Health and Human Services; Natural Resources; and Education, Early Childhood and Workforce, as well as a Special Committee on Homeland Security and Public Safety.
 

The Annual Meeting will conclude with the installation of incoming NGA Chair Nebraska Gov. Dave Heineman and the incoming Vice Chair, who will be announced at the meeting. In addition, Gov. Heineman will unveil his 2011-2012 Chair's Initiative.
(Contact: Lauren Stewart)