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.

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

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

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.”

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.

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:

Kansas Supreme Court Staffer, CSG Toll Fellow Jurgensen Named to CSG Chief, Director Roles

Shawn Jurgensen, a 2022 Toll Fellow and former CSG National Executive Committee member, officially joined CSG as its new chief public policy officer and director of the CSG Center of Innovation.

“I was pleased that the search for this position generated a pool of exceptional candidates,” said David Adkins, CSG executive director and CEO. “Shawn rose to the top of the list because of his demonstrated expertise in strategically crafting three branch solutions to public policy challenges, his considerable interpersonal skills, his passion for public service and a management style that will help advance the best qualities of our workplace culture.”

Since 2016, Jurgensen has served in the judicial branch. In 2017, he started his role as special counsel to Kansas Chief Justice Marla Luckert. His work allowed him to serve as a liaison for the chief justice, the Kansas Supreme Court and the judicial branch. Before serving as special counsel, Jurgensen served as a staff attorney in the Kansas Office of Judicial Administration and in the private sector as partner at a Kansas law firm.

“I’m thankful for the partnerships I helped build, but there are many others including Chief Justice Luckert and the Supreme Court, our Court of Appeals and district courts, legislative leadership, innumerable legislators and staff colleagues, and the governor’s office who helped with these historic achievements. Serving in this position has been the privilege of a lifetime. I hold our judges and employees in the highest regard for their commitment to delivering justice fairly and impartially.”
— Shawn Jurgensen,
CSG Chief Public Policy Officer/Center of Innovation Director

In a press release, Luckert said Jurgensen played a critical role in the work of the Kansas judicial branch during his tenure.

“Shawn has been a highly valued member of the judicial branch team, and he’s done exceptional work representing the interests of our judges and employees before the Legislature,” Luckert said. “Personally, I’m thankful for and proud of Shawn’s work to build stronger partnerships with our sister branches of government. He has played a critical role in positioning the judicial branch so it can better serve the people of Kansas.”

In his role as special counsel, Jurgensen diverted the state court system funding source to provide more stability as well as raising pay for judicial employees equivalent to market rates and increasing judicial staffing to meet department needs.

Jurgensen is a graduate of Washburn University School of Law in Topeka, Kansas, where he was the recipient of the John K. Kleinheksel Prize in Oral Advocacy. He was awarded the Pro Bono Legal Services Award in 2010 by the Topeka Bar Association.

DOL Continues Funding of CSG-led CAPE-Youth to Support Disabled Youth Employment Initiatives

CSG joins ODEP, Cornell University, San Diego State University and the National Association of Workforce Development Professionals for additional work on the Center for Advancing Policy on Employment for Youth to promote inclusion.

WASHINGTON – The U.S. Department of Labor announced the award of a $7.5 million, five-year cooperative agreement to continue support for a policy center aimed at boosting disabled youth employment.

Administered by the department’s Office of Disability Employment Policy, the agreement will provide $1.5 million annually for the agency’s Center for Advancing Policy on Employment for Youth (CAPE-Youth). ODEP created the center in 2019 to enhance national, state and local workforce systems, focusing on improved outcomes for youth with disabilities, especially those from underserved communities. The Council of State Governments oversees the development and management of CAPE-Youth.

“We are extremely excited that we have been given the opportunity to continue working on this amazing project,” said Lindsay Lucas, CAPE-Youth project manager at The Council of State Governments. “With the workforce rapidly changing due to technological advances, it is critical that we make sure youth and young adults with disabilities and the systems that support them can adapt to the changing landscape.”

As states strive to promote workforce inclusion, youth with disabilities are a key part of the solution. Over 1.3 million young people between the ages of 16 and 24 have a disability. Through research, partnerships and shared best practices, CAPE-Youth works to improve employment outcomes for youth and young adults with disabilities by helping states build capacity in their youth service delivery and workforce systems.

CAPE-Youth is a collaboration between ODEP, CSG, the K. Lisa Yang and Hock E. Tan Institute on Employment and Disability at Cornell University, San Diego State University Interwork Institute and the National Association of Workforce Development Professionals.

“Our partners have a wealth of experience and knowledge in this arena, and we are looking forward to continued collaboration and new work from the center,” Lucas said.

About The Council of State Governments
The Council of State Governments is America’s largest organization of state officials and the nation’s only nonpartisan, not-for-profit organization serving all three branches of state government. Founded in 1933, CSG is a region-based forum that fosters the exchange of insights and ideas to help state officials shape public policy to help communities across the nation and advance the common good.

2023 Toll Fellowship Welcomes Top Leaders, Strengthens Bipartisan Bonds

The Council of State Governments welcomed 44 state leaders from across the nation to its headquarters in Lexington, Kentucky, to participate in the 2023 CSG Henry Toll Fellowship — the nation’s premier leadership development program for state government officials.

The program’s name honors Henry Wolcott Toll, a former Colorado state senator and the driving force behind the formation of CSG in 1933.

Each year, the Toll Fellowship program gathers the nation’s top officials from all three branches of government to engage in an intense leadership boot camp and forge connections that span political affiliation. This year’s class was challenged through various development sessions while also being encouraged to build relationships with fellow lawmakers. For Georgia Rep. Shelly Hutchinson, this aspect of the program was one of the most important.

I will definitely be taking back the relationships. That, to me, is one of the most important parts of politics. All of the people that I’ve met, and even the people at CSG that I have not met, are the ones I can call on when I need something.

Rep. Shelly Hutchinson, Georgia

When asked about his biggest takeaway from the program, Maryland Sen. Cory McCray echoed Hutchinson’s sentiment.

“The relationship building and being able to understand some of the dynamics that are happening across the states,” McCray said.  “I think the exercise from day two played an important role in that. We had to move as a team with a number of instructions. As it got more rigorous, and we accomplished that goal, it went into a second goal that got even more challenging and required even more work as a team. It’s a great program, a great opportunity and I’m glad to be here.”

Lorna Patches, CSG deputy director of membership and leadership development, said that regardless of experience or title, there is benefit in the Toll Fellowship for all state leaders.  

“The Henry Toll Fellowship is a foundational program for state leaders forging connections across states, parties and experience levels,” Patches said.  “Our class members come together for personal exploration and creative problem solving. By doing so, these individuals form bonds that will last a lifetime and carry them back to their careers in public service and beyond. The Council of State Governments is honored to provide this development opportunity each and every year to those who are working so hard for their constituents.” 

The program is designed to draw leaders out of their comfort zone and challenge them in unique ways. However, through that shared vulnerability, Tolls connect with one another on a deeper level, regardless of which side of the aisle they support.

“I appreciate the fact that we can come together as democrats, republicans or independents and we can really talk to each other and get to know each other in an unthreatening environment,” said Washington Rep. Cindy Ryu.

The 2023 Toll Fellowship class joined a network of alumni including five state or territory house speakers, three sitting state Supreme Court justices, 10 sitting members of Congress, five sitting governors and more than 200 Toll alumni currently serving as state or territorial legislators.

Since 1986, there have been more than 1,350 graduates of the Toll Fellowship.

About The Council of State Governments
The Council of State Governments is our nation’s only organization serving all three branches of state government. CSG is a region-based forum that fosters the exchange of insights and ideas to help state officials shape public policy. This offers unparalleled regional, national and international opportunities to network, develop leaders, collaborate and create problem-solving partnerships. For more information about The Council of State Governments, visit csg.org.

Wisconsin’s Braided Funding Efforts

By Enmanuel Gomez Antolinez

While numerous public, private and nonprofit programs and services are available to support the employment of youth and young adults with disabilities (Y&YADs), a lack of coordination between stakeholders can result in service gaps and duplication. Wisconsin used braided funding strategically to increase coordination and alignment between employers, service providers, education sponsors and workforce systems, enhancing Y&YADs services and outcomes. Braided funding is a financing method that uses multiple funding streams to support the total cost of a program or service. It ensures that funding goes where it is most needed, encourages interagency coordination and ensures the appropriate program and administrative costs are properly charged to each separate funding stream. According to the U.S. Department of Labor, Office of Disability Employment Policy, braided funding can be used to:

  • Support an individual with a disability with the goal of pursuing, gaining, or keeping Competitive Integrated Employment (CIE),
  • Support Pre-Employment Transition Services, and
  • Support post-secondary preparation and transition activities.

The U.S. Department of Health and Human Services’ “Braiding Federal Funding to Expand Access to Quality Early Care and Education and Early Childhood Supports and Services: A Tool for State and Local Communities” discusses this in more detail.

While this tool has an early education focus, the analysis it utilizes is equally applicable in a transition setting. Specifically, as outlined in the tool, states and local governments may consider implementing the following strategies to support and expand transition services to Y&YADs through braided funding by:

  • Identifying funding streams.
    • Identify what funding sources are available in your state or locality and identify how this funding can be used to achieve specific goals.
  • Developing an inventory of funds known as a fiscal map, directed toward a particular population (e.g., Y&YADs) or service group. A fiscal map can be used to:
    • Recognize duplicative funding streams as well as gaps in funding.
    • Establish methods to use funds more strategically.
  • Identifying eligible populations and comparing funding requirements.
    • For many funding streams, there are rules and restrictions that govern the use of the funds. Therefore, it is important to identify eligible populations and understand the differences in eligibility and reporting requirements among various funding streams available in your state or locality.
  • Building and initiating data-sharing agreements to make it easier for state and local organizations to braid funds.
  • Developing shared goals and a plan for collaboration.
    • Permit local agencies, organizations, task forces, councils or committees to perform coordinated planning and funding functions outside a formal state framework.
    • Use interagency planning groups to coordinate funding for specific objectives.
  • Building state or local programs that use multiple funding streams rather than leaving it to individual provider level to pursue different funding streams.
  • Developing governance structures to support collaboration between agencies and other key players in state or local entities.

Wisconsin is one state that engages in braided funding to support Y&YADs. Wisconsin’s 2020-23 Combined State Workforce Innovation and Opportunity Act (WIOA) Plan prioritizes and directs state agencies to identify opportunities for braided funding to provide effective employment services to individuals with disabilities. Wisconsin’s WIOA Plan also directs cost-sharing to be negotiated among state entities, such as education, vocational rehabilitation (DVR) and local entities such as long-term care and mental health agencies. For example, cost-sharing may be negotiated among DVR, the school district and long-term care or mental health programs when there is an overlap in educational and employment/rehabilitation goals and services. This negotiation increases coordination between the various parties to ensure their specific funds contributed to the program or service are used for their designated purposes.

Similarly, the Wisconsin Departments of Health Services, Workforce Development and Public Instruction developed a comprehensive Transition Action Guide (TAG). This guide outlines a strategic approach to help Wisconsin state and local governments identify overlaps or gaps in service provision in the areas of communication, coordination and service delivery for Y&YADs transitioning from school to work. It lists funding sources and their eligibility requirements so agencies can pursue braided funding opportunities. The resource also discusses cost-sharing agreements among agencies and when these agreements are appropriate.

For more information and state examples of the benefits of braided funding efforts, review CAPE-Youth’s “Improving Transition Services for Youth and Young Adults with Disabilities through Braided Funding.”

CSG, The Turnout Launch New Initiative with Microsoft Support to Increase Voter Confidence

Today, The Council of State Governments announces a partnership with its longtime collaborator in the election space, The Turnout, to form the Election Technology Initiative (ETI). The ETI will support and develop open-source technologies for election administrators to improve the security and transparency of U.S. and international elections as well as increase voter confidence, accessibility, and participation. 

“State election officials are among the heroes of our democracy. They consistently carry out free and fair elections with professionalism and integrity. With the leadership of Microsoft, election officials now have new tools to assure citizens that their vote counts,” said David Adkins, executive director/CEO of The Council of State Governments. “CSG is proud to launch the Election Technology Initiative in partnership with The Turnout to enhance voter confidence in elections.”

The initiative will begin with the transition of ElectionGuard, the open-source software program developed by Microsoft’s Democracy Forward Initiative, to the ETI. ElectionGuard provides voting system vendors and election administrators the capability to perform end-to-end verifiable elections and post-election audits. ETI will provide the governance structure of the ElectionGuard codebase and oversee its implementation of end-to-end verifiability. RC Carter will join The Turnout and continue to lead the project. Dr. Josh Benaloh, one of the core and earliest contributors of the cryptographic foundations ElectionGuard is based upon, will continue to serve as principal technical advisor to the project and oversee the ElectionGuard specification, and Microsoft Research will continue to contribute important implementations of the specification and codebase.

“The Turnout is excited to partner with CSG on the Election Technology Initiative to bring additional layers of accountability, accessibility, and transparency to elections; building on the foundation that Microsoft set for us,” said Jared Marcotte, president of The Turnout. “We’re also happy to announce that RC Carter will be joining our team of election technology experts. It’s a rare gift to have someone who’s been with a project since its inception, has a clear and specific vision for its growth and development, can liaise and manage the various development teams, and can effortlessly explain a highly technical project to any audience. That’s RC.”

ElectionGuard was announced at Microsoft BUILD in 2018. Its first public election occurred in Fulton, Wisconsin, in February 2020 with VotingWorks. After a partnership with Hart InterCivic announced in July 2021, ElectionGuard was used in the November 2022 General Election in Franklin County, Idaho, in conjunction with Hart, Enhanced Voting, MITRE, and the Center for Civic Design.

“At Microsoft, we are working with our partners to create technology solutions that can safeguard the electoral process around the world. Four years ago, we launched ElectionGuard as a new open-source contribution to the development of secure, transparent, and accessible voting systems,” said Ginny Badanes, senior director of Microsoft’s Democracy Forward program. “Today, we are transitioning ElectionGuard to the Election Technology Initiative so they can continue this important work. With Microsoft’s ongoing support, CSG and The Turnout are the right team of trusted experts to advance ElectionGuard’s mission of empowering voters to verify that their vote counted.”

What is End-to-end Verifiability?
End-to-end verifiability (e2e-v) uses advanced cryptography and security software to create a public encrypted copy of the tally and of each ballot used in an election. Voters can verify that their ballots were included in the final tally and independent verifiers can be built to confirm the tallies derived by the ballots are correctly counted.

E2e-v is the only mechanism other than paper ballots that allow for software independence, a key requirement of systems certified under the Election Assistance Commission’s Voluntary Voting System Guidelines 2.0 standards. It’s also the only technology that can achieve software independence across both paper-and non-paper-based systems, which makes it a critical enabler of additional voting methods and improving accessibility generally. ElectionGuard is currently the only comprehensive end-to-end verifiability system under development in the U.S.

About The Council of State Governments
CSG is America’s largest organization of state officials and the nation’s only nonpartisan, not-for-profit organization serving all three branches of state government. Founded in 1933, CSG is a region-based forum that fosters the exchange of insights and ideas to help state officials shape public policy to help communities across the nation and advance the common good.

About The Turnout
At the intersection of technology and election infrastructure, The Turnout works to help governments better understand and assess military and overseas voting, to perform security self-assessments and upgrade their cybersecurity, to visualize and analyze their processes, and to standardize and validate their elections data.

Latest ‘Guideposts for Success’ Offer State Leaders Tools to Educate, Support Employers

By Trey Delida

Since 2005, the “Guideposts for Success” have equipped state leaders with up-to-date, innovative practices that increase the opportunities for youth and young adults with disabilities to transition into the workforce.

The latest brief, “Guideposts for Success: States Engaging Employers through Policy,” serves as a model for policymakers by providing them with the tools necessary to educate and support employers in their states in hiring or providing learning opportunities for youth and young adults with disabilities.

According to Andrew Karhan, project director at San Diego State University’s Interwork Institute, the brief draws on state examples and actual conversations with employers who have experience in this process. As part of the project, Karhan collaborated with the Center for Advancing Policy on Employment for Youth (CAPE-Youth).

“The brief was compiled through a deep dive into research, the current best practices related to employer engagement and the comparable employer practices towards enhanced inclusion,” Karhan said. “Some previous policies in this space have not had the intended impact. Therefore, this brief was approached through a lens of improvement science, where we asked how we can introduce change ideas leading to improvement?  The ideas presented here were born out of this research and conversations with employers and experts in the field to ultimately lead to these improvement ideas.”

The “Guideposts for Success: States Engaging Employers through Policy” is founded on six policy considerations, including:

  • Developing structures for states to become model employers of youth and young adults with disabilities.
  • Simplifying current incentives and introducing new incentives to encourage employers to develop inclusive workplace practices.
  • Facilitating telework to adapt to changes in the world of work.
  • Educating employers about the business case for their participation and support of youth and young adults with disabilities in work preparation programs.
  • Assembling tools guided and developed in partnership with national centers and employer organizations and disseminating them at the state and local levels.
  • Enhancing existing state workforce systems to foster equitable access.

The policy framework provides lawmakers and state leaders with evidence-based practices to aid youth and young adults with disabilities when obtaining employment through improved education.

“As youth transition into postsecondary environments or employment, it is critical for us to lay the necessary groundwork for them to move into employment in their field of interest and skill,” Karhan said. “The low employment outcomes of youth and young with disabilities have been well documented and, as a result, this brief offers new approaches and policy levers to help change this narrative.”

The development of “Guideposts for Success: States Engaging Employers through Policy” was led by CAPE-Youth, and is a collaborative effort of the U.S. Department of Labor Office of Disability Employment Policy, The Council of State Governments, the K. Lisa Yang and Hock E. Tan Institute on Employment and Disability at Cornell University, and the Interwork Institute at San Diego State University.