Capital Closeup: In years ahead, Kansas will rely on outside commission to make changes in legislative pay

Kansas has joined the handful of other Midwestern states that employ a commission-style approach to setting the salaries of legislators. The change in practice is the result of this year’s SB 229. During the 2023 session, lawmakers made $88.66 per day, a figure that hasn’t gone up since 2009, according to the Kansas Reflector.

The concern in Kansas, as well as some other Midwestern states, is that unchanging, low levels of compensation keep many people from being willing or able to serve.

Under the new Kansas law, a nine-member commission (appointed by the Legislature, but with no current legislators on it) is tasked with studying compensation rates and retirement benefits and then issuing recommendations every four years. Minus legislative action, the commission’s recommendations on legislative compensation take effect (the first such change will be in 2025.)

In 2016, Minnesota voters overwhelmingly approved a constitutional amendment creating the independent Legislative Salary Council, which now sets legislative salaries every two years. The most recent change took effect in July and bumped annual pay up to $51,750. Prior to the council’s formation, legislative pay in Minnesota was $31,140 per year and had gone unchanged for a decade and a half.

The pay of legislators in Wisconsin is included in a compensation plan that covers other state elected officials as well as state employees. Developed by the Department of Adminstration (an executive branch agency), the plan must get approval from a joint legislative committee. Michigan has a State Officers Compensation Commission, but any of its recommended changes to the pay of legislators must be voted on and approved by the House and Senate.

Nebraska is the only Midwestern state where salaries are constitutionally prescribed; as a result, any change in legislative pay in that state — currently $12,000 a year — requires voter approval.

Two states in the region have statutory language that automatically adjusts legislative pay: in South Dakota, annual changes make the salary equal to 20 percent of the state’s median income; and in Indiana, the pay level is equal to 18 percent of the salary for trial court judges.

Minus the use of commissions or statutory formulas, legislators typically must initiate and then approve changes in their own pay. In early 2023, the Illinois General Assembly bumped up the annual legislative salary to $85,000; an automatic cost-of-living increase of 5 percent also took effect with the passage and signing of the state’s new state budget.

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Southern Pulse Newsletter, September 2023

The sun sets earlier, soup ingredients are being purchased, and temperatures are cooling, but here at CSG South, we are just getting heated up!  

It has been a month jampacked with traveling and preparation for our team, and we are thrilled to roll out all the programming, publications, and leadership development planned for the remainder of the year.  

Our first Policy Masterclass, Leveraging Learning Loss: A Public Policy Approach, was hosted in Atlanta this week. Attendees learned from industry experts, toured the Capitol, and met with State Superintendent Richard Woods. Our next Policy Masterclass, The Opioid Crisis: Understanding and Addressing the Public Health Emergency, will occur in Kansas City, Missouri next month.  Our final Policy Masterclass, All of the Above: Ensuring Energy Independence, explores how states seek to expand their portfolios with an “all of the above” energy strategy, emphasizing West Virginia’s energy strategy – the 5th largest state for energy production. 

We are excited to welcome and congratulate the Center for the Advancement of Leadership Skills (CALS) class of 2023 after an overwhelming and competitive response. The leadership development doesn’t end there, with our Staff Academy for Governmental Excellence (SAGE). We can’t wait to meet both CALS and SAGE classes this fall! To learn more about our leadership development programs, click here.  

As the busy time of fall is about to kick off, you can always be connected to us through this newsletter, our CSG South website, and social media for updates.

We hope you continue to utilize our team as an extension of your office and know that we are always here to assist you.  

All the best,
Lindsey G.

Click here to read Southern Pulse- September 2023

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CSG Associates Organize Recovery Efforts Following Hawaii Wildfires

By Katie Boggs, CSG Advancement Fellow

The devastating early August wildfires in Maui, Hawaii, were fueled by the arrival of Hurricane Dora, a category four storm. On Aug. 8, the fire’s blazes spread, making parts of the island nearly unrecognizable. Officials said most of the fires have been contained, however, the number of confirmed deaths continue to rise.

Many CSG Associate members took action to help those that were displaced and impacted by the natural disaster. Aid in the form of monetary donations, supplies, health care and network services have all been implemented to support Hawaii.

Amazon Partners with Disaster Relief Programs to Battle Maui Wildfires
Amazon is partnering with local Hawaiian and national disaster aid programs to provide needed supplies and support on the ground following the deadly wildfires.

Amazon launched its Disaster Response team within 72 hours of the fires. The company, through Amazon Air, flew in critical supplies like tarps, tents, coolers and totes to the American Red Cross who were already active on the ground. After short and long-term relief needs were estimated by officials, Amazon has been able to provide aid in the form of emergency assistance items and financial support on the ground.

“Everyone at Amazon is eager to help, as the situation is truly heartbreaking,” said Abe Diaz, principal technical product manager for Disaster Relief by Amazon. “We’re in contact with organizations on the ground to assess additional needs and determine how we can use our inventory, infrastructure and connectivity technology to help communities as soon as possible — from item donation to helping reestablish internet.”

On the ground, Amazon partnered with organizations such as the Council for Native Hawaiian Advancement, Hawaii Chamber Foundation Business Relief Fund, Information Technology Disaster Resource Center, Feeding America and Operation BBQ Relief.

For more information, please visit: https://www.aboutamazon.com/news/community/maui-fires-amazon-disaster-relief.

Teladoc Health Offers 24/7 Telehealth Services to Those Impacted by Hawaii Wildfires
Teladoc Health, the largest global virtual health care provider, is focused on making general medical care needs accessible to Hawaiian residents and first responders displaced due to the fires.

Through the use of their natural disaster hotline, the organization is offering free, 24/7, easy-to-access telehealth services from licensed health care professionals. Non-emergency services, including mental health treatment, are provided.

“When medical resources are already strained during natural disasters, virtual care can help patients manage wildfire-induced flare ups of chronic illnesses, such as asthma,” said Dr. Vidya Raman-Tangella, chief medical officer at Teladoc Health. “Virtual care is a proven solution that supports community health during these times, and we are grateful to provide access to care as Hawaii rebuilds and recovers from the fires.”

For more information, please visit: https://www.teladoc.com/disaster-hotline/.

The Credit Union National Association Donates $20,000 for Hawaii Wildfire Relief
Through CUNA’s CUAid: Disaster Relief program, the organization provided monetary assistance to Hawaiians. An additional $10,000 was allocated to the Maui Food Bank, the island’s safeguard for food security.

“The people of Maui are in need of immediate help to recover from these devastating wildfires, and this contribution was recommended by our friends at the Hawaii Credit Union League as a way to help with efforts to take action,” said CUNA President/CEO Jim Nussle.

For more information, please visit: https://www.ncuf.coop/disaster-relief/.

AT&T Works to Recover Communications in Hawaii and Raises $100,000 for Relief
AT&T raises funds for Hawaii wildfire relief, while its ground efforts focus on restoring network and mobile connectivity across Hawaii, ensuring public safety.

AT&T’s Network Disaster Recovery front, alongside with the FirstNet Response Operations Group worked with local officials to provide five portable cell sites and wireless networks for Hawaiian residents and first responders. As of Aug. 19, coverage in all impacted areas of Maui County has been restored, however the team is still working on ensuring permanent connectivity among the islands.

Partnering with other organizations, AT&T has also been providing devices to Hawaiians that have lost their phones in the fires. Motorola, Samsung and Google donated devices to help connect locals with their loved ones and access relief resources.

Additional efforts have been geared toward working with national disaster relief teams. Through the Mobile Giving Foundation, AT&T implemented four ongoing text-to-give campaigns providing anyone with a mobile phone the opportunity to contribute. In addition, AT&T contributed $100,000 to aid recovery efforts for Maui residents and communities. Half of the donation was allocated to the Hawaii Community Foundation, $30,000 to the Information Technology Disaster Resource Center and $20,000 to the American Red Cross.

For more information, please visit: https://about.att.com/pages/disaster-recovery/2023/maui-wildfires.

Honda Raises $500,000 and Offers to Match Associate Donations for Hawaii Relief
Honda companies in the United States donated $500,000 for humanitarian relief efforts toward those affected by the wildfire damage to Maui, Hawaii.

Alongside the original fund that was collected, Honda is also offering its associates the opportunity to be involved in helping Hawaii recover. The organization announced they will match donations up to $1,000 per associate. All money raised goes to help the American Red Cross. In addition, the organization is working with its Hawaii Honda Dealers network in support of the Hawaii Community Foundation.

For more information, please visit: https://hondanews.com/en-US/honda-corporate/releases/release-e888887b6471c0aba407829ba70c3335-honda-contributes-500000-to-maui-hawaii-wildfire-relief-efforts#press-release.

About CSG Associates in Action
Associates in Action articles highlight CSG Associates’ philanthropic efforts and public-private partnerships throughout the states.

About Amazon
Amazon is guided by four principles: customer obsession rather than competitor focus, passion for invention, commitment to operational excellence and long-term thinking. Amazon strives to be Earth’s most customer-centric company, Earth’s best employer and Earth’s safest place to work. Customer reviews, One-Click shopping, personalized recommendations, Prime, Fulfillment by Amazon, AWS, Kindle Direct Publishing, Kindle, Career Choice, Fire tablets, Fire TV, Amazon Echo, Alexa, Just Walk Out technology, Amazon Studios, and The Climate Pledge are some of the things pioneered by Amazon.

About Teladoc Health
Teladoc Health empowers people everywhere to live their healthiest lives by transforming the health care experience. As the world leader in whole-person virtual care, Teladoc Health uses proprietary health signals and personalized interactions to drive better health outcomes across the full continuum of care, at every stage in a person’s health journey. Teladoc Health leverages more than two decades of expertise and data-driven insights to meet the growing virtual care needs of consumers and healthcare professionals. For more information, please visit www.teladochealth.com or follow @TeladocHealth on X, formerly known as Twitter.

About CUNA       
Credit Union National Association advocates on behalf of America’s credit unions, which are owned by more than 135 million consumer members. CUNA, along with its network of affiliated state credit union leagues, delivers unwavering advocacy, continuous professional growth and operational confidence to protect the best interests of all credit unions. For more information about CUNA, visit cuna.org. To find your nearest credit union, visit YourMoneyFurther.com.

About AT&T      
AT&T helps more than 100 million U.S. families, friends and neighbors, plus nearly 2.5 million businesses, connect to greater possibility. From the first phone call over 140 years ago to our 5G wireless and multi-gig internet offerings today, AT&T innovates to improve lives. For more information about AT&T Inc., please visit us at about.att.com. Investors can learn more at investors.att.com.

About American Honda Motor Co., Inc.     
Established in Los Angeles in 1959, and currently headquartered in Torrance, California, American Honda Motor Co., Inc., leads the U.S. sales, marketing, service, distribution and export of Honda and Acura automobiles, Honda powersports, power equipment and marine products, along with design, planning and market research for products that are produced at Honda’s North American production facilities. Learn more through Honda’s Digital FactBook.

States discuss regional strategies to address PFAS

In recent years, a growing number of states have established policies to address contamination from per- and polyfluorinated alkyl substances (PFAS), which have been used in the manufacture of thousands of products, including cookware, cosmetics, food packaging, carpets, and firefighting foams. There are thousands of different PFAS, some of which have been more widely used and studied than others. One common characteristic is that PFAS do not break down in the environment or in our bodies – and hence, they have been dubbed “forever chemicals.”

During a panel discussion at the 2023 CSG East Annual Meeting in Toronto, Ontario, Maine State Representative Lori Gramlich described a situation that she called the “perfect storm.”

In November 2016, Fred Potter, a dairy farmer, learned that his water contained PFAS at levels that were two times higher than what the U. S. Environmental Protection Agency considered to be safe. Potter later learned that the PFAS contamination stemmed from the spreading of municipal sludge back in 1986. The PFAS levels were so alarming that Potter could no longer sell the milk produced by his dairy cows. He had to euthanize most of the herd. “And he and his family have been plagued with health problems ever since,” said Gramlich.

During Gramlich’s first term in the legislature in 2019, she learned about Potter’s experience from a colleague who represented his district. Since then, Maine has become a leader in addressing PFAS contamination. Governor Janet Mills created a task force bringing together state agencies and other stakeholders to explore the extent of PFAS contamination in the state and create a plan to address it. Gramlich, who serves as House chair of the Environment and Natural Resources Committee, introduced several measures that have been enacted, including legislation that requires transparency from manufacturers who add PFAS to their products, and will compel them to phase out their use in Maine.

During the panel, Gramlich was joined by Rhode Island State Representative Terri Cortvriend, and Maryland State Senator Katie Fry Hester, who discussed efforts among them and their colleagues to assess the extent of PFAS contamination in drinking water, pesticides, and other products; remediate where possible; ban or phase out their use in a wide range of products; and promote safer alternatives.

Given the pervasiveness of PFAS contamination and broad concerns about how to protect communities from harm, several members suggested that CSG East organize a regional summit in the coming months, to convene officials from all three branches with a range of experts to explore alternatives to PFAS and discuss best practices.


CSG East looks forward to continuing this important conversation with our members going forward. You can sign up for future meeting notices via Constant Contact using this link.

2023 STAR Award Winners – VADOC Voice Verification Biometrics Unit

The Southern Legislative Conference’s State Transformation in Action Recognition (STAR) award recognizes impactful, creative, effective, and transferable state government solutions. Innovative program submissions are accepted from various state agencies, departments, and institutions operating within the executive, legislative, and judicial governmental branches.

The 2023 STAR Award Recipient is The Virginia Department of Corrections’ Voice Verification Biometrics Unit. To read more about the award winner click below.

VADOC Wins Fourth STAR Award at Southern Legislative Conference — Virginia Department of Corrections

Click here to read more about our STAR Award

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Leaders Examine Representation in State Government Workforces at the CSG State Exchange on Public Servant Recruitment and Retention

State leaders from five states — Colorado, Idaho, Mississippi, New Hampshire and New York — gathered in Denver in September to discuss and set goals to recruit and retain diverse and representative talent in the state government workforce.

The Council of State Governments partnered with Representative Democracy for the CSG State Exchange on Public Servant Recruitment and Retention.

In the U.S., state governments employed 3,825,097 full-time workers in 2022, around 1.5% of the total population. This makes state governments one of the largest employers in the country. However, in recent years state government employment growth has lagged behind the growth seen in the private sector. By the end of 2022, state and local government employment as still 2.3% below pre-pandemic levels, according to the Economic Policy Institute, driven largely by vacancies in public education and public health. Creating robust and diverse pipelines to state government career is one way to fill these job shortages in the coming years.

“I’m leaving here feeling like we’re not so alone,” said Rosina McNeil-Cusick, director of equity for the Colorado Department of Personnel and Administration. “Knowing Colorado isn’t the only state trying to solve these hiring problems.”

Through legislation, executive orders and other actions and policies, states take a variety of approaches to recruiting and retaining public employees from different backgrounds, including the development of equal opportunity offices, the creation of apprenticeship and internship programs, providing opportunities for veterans and individuals with disabilities, and removing barriers to employment.

At the state exchange, state leaders swapped ideas about recruiting new talent, creating a culture that would inspire state workers to continue their employment, opportunities for competitive wages and benefits, leadership development and more.

“We’re finding that the person making the biggest difference in culture starts at the top,” said Lori Wolff with the Idaho Division of Human Resources. “We have to invest in our leaders.”

Ahead of the program, CSG developed a series of resources analyzing the state government workforce. Those resources are available here:

CSG Promotes Telehealth Awareness Week with Spotlight on Advocacy, Legislation

In recognition of Telehealth Awareness Week, The Council of State Governments joins the American Telemedicine Association to highlight a national need for consistent, quality care for patients in both in-person and virtual settings. Observed Sept. 17-23, participation in this year’s third annual event is encouraged by telehealth providers, hospitals, medical practices, advocates, policymakers and other stakeholders.

Concurrent with Telehealth Awareness Week, an ATA Action meeting was held Sept. 18-19 in Washington, D.C., with members of Congress discussing federal virtual care policies and issues impacting access to telehealth services.

Leaders at the state level have also been active in supporting telehealth legislation. Since Telehealth Awareness Week’s launch in 2021, temporary orders implemented as result of the COVID-19 pandemic have transitioned telehealth into permanently enacted measures for many states. Actions at the state level include reducing regulations associated with telehealth, and allowing in- and out-of-state practitioners to deliver telehealth services.

A detailed look at legislation addressing telehealth that has already been enacted or currently under review can be found below for 2022 and 2023.

2023 Telehealth State Legislation

StateLegislationStatusSummary
CaliforniaAB 1241Signed by the governor on Sept. 8, 2023.Authorizes telehealth providers to meet Medi-Cal in-person referral requirements by maintaining protocols for patient referral to appropriate in-person care, when the standard of care cannot be met by video synchronous interaction or audio-only synchronous interaction.
CaliforniaAB 232Enrolled on Sept. 11, 2023.Extends authorization for a person who holds a license in another state as a marriage and family therapist, clinical social worker or professional clinical counselor to provide services in the state for a period not to exceed 30 consecutive days in any calendar year if certain conditions are met.
CaliforniaAB 1369Enrolled on Sept. 11, 2023.Known as the David Hall Act, the bill allows a person licensed and in good standing as a physician and surgeon in another state would be authorized to deliver health care via telehealth to a patient who has a disease or condition that is immediately life-threatening and meets other statutory requirements for care.
ConnecticutSB 3Signed by the governor June 26, 2023.This legislation establishes standards concerning consumer health data and prohibits geofencing of certain health data among other provisions, among other actions.
District of ColumbiaB 25-125Notice of Intent to Act on B25-0125. Published in the District of Columbia Register. Referred to Committee on Health on Feb. 24. 2023.As introduced Bill 25-125 would provide that licensed health practitioner in the District may provide health care through telehealth. It also expands the circumstances under which qualified our -of -state practitioners are permitted to deliver telehealth services to patients located in the District.
FloridaHB 267Approved by the governor on May 11, 2023.Modifies the definition of telehealth to allow audio-only phone calls as a permitted telehealth modality.
FloridaSB 264Signed by the governor on May 8, 2023.A health care provider that utilizes certified electronic health record technology must ensure that all patient information stored in an offsite physical or virtual environment is physically maintained in the continental United States or its territories or Canada.
HawaiiHB 907Transmitted to the governor on May 3, 2023.Clarifies that telehealth services provided by way of an interactive telecommunications system can be temporarily reimbursed to comply with Federal guidelines.
IdahoHB 61Signed by the governor on March 27, 2023.Adopts Interstate telehealth licensure for mental and behavioral health.
IdahoHB 162Signed by the governor on March 21, 2023.Clarifies a prescriber-patient relationship can be established for the purposes of prescribing via telehealth. The bill also allows for cross-state practice without an Idaho license in certain circumstances.
IllinoisSB 48Re-referred to Assignments on March 31, 2023.Amends the Medical Assistance Article of the Illinois Public Aid Code, specifically on issues of vendor enrollment.
IndianaHB 1352Signed by the governor on May 4, 2023.Beginning Jan. 1, 2024, the office of Medicaid policy and planning may not require a licensed provider offering telehealth services to maintain an address in the state or that a telehealth provider group licensed in the state have an in-state address to be eligible for enrollment as a Medicaid vendor or Medicaid provider group.
KentuckyHB 311Signed by the governor on April 6, 2023.Prohibits the Department for Medicaid Services and any Medicaid managed care organization from requiring health professionals or medical groups exclusively offering telehealth services to maintain a physical location or address in Kentucky to be eligible for enrollment as a Medicaid provider.
LouisianaSB 66Signed by the governor on June 12, 2023.Effective Jan. 1, 2024.Amends and re-enacts provisions relative to telemedicine, namely by using “telehealth” as conforming language. The bill specifies that telehealth includes a physician’s practice of medicine when conducted through electronic communications.  State agencies are now required to promulgate telehealth rules. Any in-person requirement physical examination or patient history before engaging in telehealth is alleviated, unless the provider is prescribing a controlled dangerous substance.
MarylandSB 534Signed by the governor on May 3, 2023.Extends the classification of certain audio-only telephone conversations under the definition of “telehealth” to June 30, 2025,   because of reimbursement and coverage of telehealth requirements by the Maryland Medical Assistance Program and certain insurers, nonprofit health service plans and health maintenance organizations.
NevadaSB 119Approved by the governor on May 29, 2023.Removes the sunset for the requirement of third-party payer who is not an industrial insurer to cover services provided through telehealth.
NevadaSB 370Signed by governor on June 16, 2023.Revises provisions relating to consumer health data.
New HampshireSB 238Passed Senate.To House for concurrence on May 18, 2023.Senate moved for nonconcur with House Amendment on June 1, 2023. The bill modifies prescribing procedure for physicians, physicians assistants and APRNs in relation to non-opioid and opioid controlled drugs when utilizing telemedicine.
New HampshireHB 500Signed by the governor on May 12, 2023.Amends prescribing requirements for opioids and controlled substances. Edits the definition of telemedicine under the Nursing Practice Act. Allows practitioners of telehealth medicine to prescribe opioids. Sets out the process for prescribing schedules II-V through telemedicine.
OregonSB 232To the governor on June 6, 2023.The bill allows physicians or physician assistants who are out of state to provide specified care to Oregonians.
Rhode IslandHB 5556/SB 574House and Senate Committees recommended the measures be held for further study.Adopts the Uniform Law Commission Uniform Telehealth Act.
Rhode IslandHB 5352/SB 965House Committee Meeting with proposed substitute postponed.  Amends the Telemedicine Act by adding a definition of patient provider relationship which states that the relationship may be defined by synchronous or asynchronous telemedicine technologies without a prior in-person meeting as long as the standard of care is met.
TennesseeSB 680Signed by the governor on March 21, 2023.Provides clarification as to the Medical Assistance Act of 1968, distinctly that the act does not require a vendor, healthcare provider or telehealth provider group providing telehealth healthcare services to have a physical address or site in Tennessee in order to be eligible to enroll as a vendor, provider or provider group for the medical assistance program.
VirginiaHB 1602/SB 1418Signed by the governor on March 21, 2023.Health care providers are not required to maintain a physical presence in Virginia to maintain eligibility to enroll as a Medicaid provider. Under the bill, telemedicine services provider groups with health care providers licensed by the Commonwealth are not required to maintain an in-state service address to maintain eligibility to enroll as a Medicaid vendor or Medicaid provider group.
WashingtonSB 5036Signed by the governor on March 30, 2023.Extends the use of both audio and video real-time telemedicine to establish a relationship for the purpose of providing audio-only telemedicine for certain health care services. Senate companion to HB 1027.
WashingtonHB 1155Signed by the governor on April 27, 2023.Known as the Washington My Health Data Act, this bill addressed the aggregation, sharing or any similar acts of personal data. 
Source: American Telemedicine Association “2023 State Legislative Tracker.”

2022 Telehealth State Legislation

StateLegislationStatusSummary
AlabamaSB 272Signed by the governor in April 2022.Provides a technology-neutral definition of telehealth; allows licensure flexibilities for providers delivering “irregular or infrequent” care and those in consultation with a licensed physician, among other requirements.
AlaskaHB 265Enrolled May 18, 2022.Enables in-state providers to deliver telehealth services without an in-person exam if the provider’s license is in good standing and mandates that out-of-state providers not licensed in Alaska only render telehealth services to patients referred by someone licensed in Alaska. The bill also discusses prescribing opioids.
CaliforniaAB 32Approved by the governor on Sept. 25, 2022.Amends the Welfare and Institutions Code in relation to telehealth
CaliforniaAB 2089Approved by the governor on Sept. 28, 2022.Holds “mental health app developers” to new privacy requirements and requires mental health app developers to register with the attorney general.
ColoradoSB 22-007Signed by the governor.The bill enacts the “Interstate Licensed Professional Counselors Compact.”
ColoradoSB 22-181Signed by the governor.Requires the Behavioral Health Administration to create and implement a behavioral health-care provider workforce plan.
DelawareHB 334Signed by the governor on Oct. 21, 2022.Permits health care providers who are licensed outside of Delaware to offer telehealth and telemedicine health care services so long as a provider-patient relationship has been established; amendment renders
most permissive provisions in this bill void.
FloridaHB 17Laid on the table. Substituted by SB 312. SB 312 was signed by the governor.SB 312 amends language to prohibit telehealth providers from prescribing only Schedule II drugs except under certain circumstances.
IndianaSB 251Signed by the governor on March 10, 2022.Indiana adopts the Interstate Medical Licensure Compact.
KentuckyHB 188Signed by the governor on March 3, 2022.Prohibits regulatory boards from certain restricting licensure flexibilities.
MississippiSB 2738Approved by the governor on April 18, 2022.Revises the definition of telemedicine in the insurance code.
New HampshireSB 390Signed by the governor on Aug. 9, 2022.Amends the definitions of telehealth and  telemedicine to include both synchronous and asynchronous technologies. The bill also enables pharmacists and physicians to establish patient-provider relationships via telemedicine.
South CarolinaSB 1179Signed by the governor on May 13, 2022.Grants out-of-state licensure reciprocity to behavioral health providers. Social workers licensed in South Carolina are allowed to provide services via telehealth methods.
TennesseeHB 2655Signed by the governor on April 1, 2022.Extends the statutory provision regulating reimbursements for health care services provided during a telehealth appointment, among other things.
UtahSB 151Signed by the governor on March 24, 2022.Enters Utah into the Advanced Practice Registered Nurse Compact.
VermontHB 665Signed by the governor on May 9, 2022.Creates a telehealth license and a telehealth registration scheme for out-of-state providers.
VirginiaB 369Approved by the governor.Allows out-of-state physicians to care for patients in Virginia via telemedicine if such practice is for the purpose of providing continuity of care and the provider already has an established relationship with the patient.
WashingtonHB 1821Signed by the governor on March 30, 2022.Amends the definition of “established relationship” in the insurance code.
Source: American Telemedicine Association “2022 State Legislative Tracker.”

As farmland comes under threat from development, ‘agrivoltaics’ is emerging as a potential option

The excitement in the roomful of legislators was palpable when they got a glimpse into a future in which solar energy and crop production may be able to coexist on the same piece of agricultural land.

Presenter Charles Gould had shown them a picture of vertical bifacial solar arrays, an “upright” system that allows for solar production “between the rows” of working farmland. It’s a potential solution to an issue of concern for the Midwestern region: how to address the increased demand for solar power, which requires substantial amounts of land, while preserving farmland for food production.

With help from Gould and Kris Reynolds of the American Farmland Trust, state and provincial legislators explored this issue in July during a session at the Midwestern Legislative Conference Annual Meeting. The session was presented jointly by two MLC committees: Agriculture and Rural Affairs and Energy and Environment.

In the Midwest, farmland seems abundant. In actuality, it is a limited national resource. According to Reynolds, between 2001 and 2016, 11 million acres of U.S. farmland were converted to other uses, predominantly low-density housing due to population growth and urban sprawl. Some farmland, however, also is and will be used to produce renewable energy. (Many crops already are turned into energy products; most notably, 30 percent of all corn produced in the U.S. is used for ethanol.)

According to U.S. Department of Energy projections, ground-based solar could require about 0.5 percent of the land in the contiguous United States by 2050; that is about one-third of the size of Ohio.

But when this prediction was made, little did researchers know that engineers at various renewable energy companies were looking to reduce solar’s land footprint. When situated in an east/west configuration, vertical bifacial solar arrays can collect 27 percent more energy than traditional southfacing, slanted arrays, Gould said. That’s because energy production peaks twice a day for vertical arrays as they capture solar energy in the morning and evening. Peak production times neatly correlate with peak energy demands, Gould said.

Though more expensive than traditional solar arrays, vertical bifacial solar arrays collect less dust and snow, thereby increasing energy output, he added.

Gould, a bioenergy educator at Michigan State University Extension, suggested that for farmers who don’t want their fields divided with solar energy systems, these systems could be used as pasture perimeters. Legislators are likely to hear more about these kinds of emerging products and technologies as they explore policies around “agrivoltaics” — the dual use of land for raising crops for food, fiber or fuel and for generating electricity.

This year, for instance, Colorado legislators passed a bill (SB 23-092) establishing new agrivoltaics-based property tax exemptions as well as a grant program to study the use of solar and farm production on the same land. Gould and Reynolds each offered their own policy ideas. Among them:

  • Consider incentives for dual-use solar and agricultural production.
  • Prioritize solar production on buildings or land not suitable for agriculture. However, don’t limit production to non-agricultural areas: Many farmers welcome the stability of revenue from solar production.
  • Design laws and regulations in a way that allow for changes in technology and flexibility in system design.
  • Ensure under-served communities are fully represented in decision-making.
  • Map your state’s agricultural land and plan for agriculture, not just around it.
  • Safeguard your state’s most productive land and invest in purchase of agricultural conservation easements (PACE), which keep this land from being taken out of production for other uses.

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Spreading the Word about Evaluations

Using Learning Agendas to Communicate Effectively with Evaluation Stakeholders

By Dr. Dakota Thomas

The Governing for Results Network is a multi-state peer learning network of state evidence leaders. The network is a collaborative effort hosted by the National Conference of State Legislatures, The Council of State Governments and The Policy Lab at Brown University. The Governing for Results Network works to foster connections across the network, and within and across state governments, by engaging with state legislators, budget directors, and legislative and agency staff who advance the use of data and evidence across branches of government.


Key Takeaways

  • Communication is critical for ensuring that evaluations are targeted toward programs and policy areas that need them, and that they are evaluated fairly and effectively. Policymakers need to know what programs are not working as intended, so that they can be improved.
  • A learning agenda can be a powerful tool for structuring communication with evaluation stakeholders. It also assists in ensuring that the right people are involved in guiding what programs are evaluated and informed of relevant evaluation results and responsive to any reforms suggested by evaluators.

For policymakers to rely on evidence to make decisions, communication is vital. An evaluation, on its own, is only helpful when used to make decisions. For that to occur, communication between researchers, program staff and other stakeholders is key. This communication should begin before an evaluation is even considered, and must continue during and after the evaluation to be effective.

The information researchers gather from talking to policymakers, program participants and the staff that implement the program daily can be invaluable for determining the direction of the evaluation and making sure it is well received by stakeholders. Researchers need help clearly communicating the implications of their work; stakeholders need accurate information to inform their decisions; and program staff need to know what is working and what needs to change.

This brief outlines how adopting a learning agenda can be used to help ensure smooth communication throughout the evaluation lifecycle. A learning agenda is a plan for using evidence, research and evaluations to improve policy and program outcomes. This includes taking the following actions:

  • Identifying the priority research questions that need to be answered based on strategic goals and the information needs of key stakeholders.
  • Assessing the existing evidence base.
  • Identifying gaps in knowledge that need to be addressed.
  • Planning to conduct research to address those gaps.
  • Engaging with stakeholders to develop and implement the learning agenda.
  • Providing the findings to those stakeholders.

The key benefit learning agendas offer as a communication framework is ensuring stakeholder engagement throughout the entire research process.

“This is a complaint I have heard many times from data/analyst folks: ‘We did this great study but nobody wants to read it.’ I think a lot of the problem is a lack of engagement between those operating government and those evaluating government. You need to talk to others before doing an evaluation to know the landscape of how an evaluation will be received. If there is no perception that there is an issue in a program, practitioners are unlikely to be interested unless there are shocking conclusions from the evaluation. Of course, this shouldn’t be the only input and an analyst might have good reason to think the collective wisdom is misplaced, but it is an important factor.”

— Jonathan Womer, The Policy Lab at Brown University

Using Learning Agendas as a Communications Framework
States and state agencies could adopt learning agendas as a tool for smoothing out communication between stakeholders (e.g., legislators), program staff and researchers. Borrowing heavily from the auditing literature, this process of using a learning agenda as ongoing communication framework should look as follows:

  • Step 1: The first step is to survey the organization/agency being evaluated. This helps to create the “evaluation universe,” an up-to-date list of evaluable programs and policies that can be updated every year. Communicating with stakeholders well in advance of deciding what to evaluate and how to do so is critical. Gathering perspectives from a diverse group of people early in development is a great way to ensure the learning agenda is well calibrated to the needs of the state or agency and the communities it serves.
  • Step 2: Prioritize and rank evaluable programs and/or policies. We cannot evaluate everything. Depending on the focus of an agency, it makes sense to prioritize the most important, newest and least tested programs for evaluation. Again, this is a great stage to seek feedback from stakeholders, including agency leadership, legislators, program staff and so on.
    • One question you should ask agency leadership and program managers is, “What keeps you up at night?” This will help you understand the key priorities that the learning agenda can help to understand and address. By asking this question, the North Carolina Office of Strategic Partnerships was able to help the state’s Department of Public Safety decide what research to pursue (see below).
  • Step 3: Create the learning agenda based on the priorities established in Step 2 (and staff capacity), create a plan for addressing the largest items on the agenda. Once the learning agenda has been drafted, seek out more feedback and incorporate that into the final draft.
  • Step 4: Perform the evaluation(s) needed. Keeping lines of communication open during the evaluation process can help prevent surprises and give program staff a chance to change course if things are not working.
  • Step 5: Share the results of the evaluation(s) with relevant stakeholders. If you have communicated regularly and built up a trusting relationship with the people who need to know what’s going on, this will be much more effective than just calling everyone in at the end to hear the results.
  • Step 6: Repeat. Learn from the process and improve for the next round of evaluations, which may be based on lingering questions from the first round.

The purpose of stakeholder engagement is to make sure that the learning agenda addresses questions that are relevant, salient, and meaningful to those with direct interests in the agency’s functions, and that the learning that results resonates with stakeholders.”

— Excerpt from M-19-23, Office of Management & Budget, Executive Office of the President

State Successes with Learning Agendas
While learning agendas are more common at the federal level, where some agencies are required to use learning agendas under the Evidence Act of 2019, states have also had success in adopting learning agendas. Consider the following examples:

Colorado’s Department of Public Health and Environment recently used a learning agenda to guide their public health efforts focused on the state’s family support programs. Colorado’s learning agenda was helpful for ensuring an inclusive group of stakeholders were involved throughout the entire evaluation process, including program directors and managers, state intermediaries, home visitors and university researchers. Thanks to early communication with those stakeholders, the agency identified mental health services as a key concern warranting further research. After consulting stakeholders again, the team found that an evaluation was appropriate for two home visiting programs. When the initial evaluation yielded mixed results, the team then examined additional research questions that revealed issues with training for one of the programs.

Findings were shared with participants, program staff and agencies, and later used to improve the identified weaknesses. Sharing the results of this study was structured and comprehensive. Researchers shared results with participants in the program, local agencies that implement the program, state intermediaries, and other similar programs in and outside of the state. The team shared results in multiple formats, including briefs, documents and newsletters, focusing on the key takeaways from the study. A learning agenda presents a great opportunity to formalize the follow up process and dissemination of results A high quality learning agenda will include a thorough plan for making the results available in many forms to the many stakeholders involved, providing multiple opportunities for them to learn, ask questions and use the information to make decisions.

Connecticut uses a learning agenda to gather all the research questions that agencies need answered into one place, and guide the data collection and analysis process to adequately answer those questions. This ensures that the state’s data system is responsive to policymakers, agencies and, ultimately, the state’s citizens. For example, the state wanted to understand the process of college admissions. Using the framework of a learning agenda to collaborate with the relevant stakeholders, researchers in the state narrowed this topic down to just a few key research questions, including:

  • What are the pre-college indicators, including student need, that correlate with the level of preparation required for a high school student to succeed in a core, credit-level course of study at a postsecondary institution?
  • To what degree does high school academic history correlate with career readiness for students who do not pursue postsecondary education after high school completion?

Guided by these informed research questions. The state’s data analysts conducted an evaluation and found several predictive pre-college indicators of success, suggested evidence-based options to improve performance, and identified areas for future research.

Connecticut’s learning agenda was especially helpful for policymakers due to the sheer number of stakeholders involved. Tackling these questions required collaboration, data sharing and analysis among 13 participating organizations, including multiple state agencies, universities and nonprofits.

Without a clear system of communication, it’s possible to fail to collect crucial data needed to answer a question, or to have multiple agencies and groups pursuing the same questions independently, and policymakers may not get the information they need to make informed decisions. The learning agenda provided a structured opportunity for all stakeholders to communicate early in the process, which helped to ensure the right research questions were being asked, the right data collected, the right programs evaluated, and the right follow up was conducted.

To develop their most recent learning agenda, the North Carolina Office of Strategic Partnerships met with leaders of the Department of Public Safety to ask, “What keeps you up at night?” The discussion revealed three priority questions related to the COVID-19 pandemic that focused on providing health care and mental health resources for offenders reentering the community, prison supervision and employment barriers for ex-offenders. Knowing these priorities, the team was able to identify external partners interested in tackling those issues.

Thanks to the structure provided by the learning agenda, North Carolina was able to recruit three teams of university-based external researchers to tackle these questions. These teams reviewed public data and available research, delivering briefs with initial findings six weeks later at no cost to the state. These findings then informed future analysis and the immediate decisions of policymakers. The learning agenda framework helped structure collaboration between the state government and universities.

North Carolina’s example illustrates learning agendas’ usefulness as a tool to seek external partners and maintain an ongoing channel of communication between policymakers, program evaluators, program managers, and external partners like university researchers. By building relationships and establishing trust, it becomes easier for policymakers to help researchers decide what programs to study, and for researchers to deliver results to policymakers in a way that will actually be useful for making decisions.

Conclusion
Communication is critical for turning evidence into effective policy. A study proving that a program is effective is useless if policymakers never actually hear about it. To ensure smooth, effective communication with all stakeholders throughout the evaluations process, researchers and evaluators should consider using a learning agenda as a communications tool to keep policymakers in the loop from the outset. Doing so can help ensure that the right programs and policies get evaluated for maximum impact, that the right people are involved in the evaluation from the beginning, and that the right people are informed of evaluation results for the  findings to be used in decision-making. State policymakers could consider requiring the use of learning agendas for state agencies, similar to the federal mandate from the Evidence Act of 2019.  Properly implemented, learning agendas can help make evidence-based policymaking easier, more accessible, and more effective.

Resources for Evaluators and Researchers: