Bipartisan Support Drives Interstate Compact Growth, Success

Fifty-seven pieces of licensure compact legislation enacted in 2023; 290 enacted since 2016.

By Jessica Thomas and Kaitlyn Bison

A recent uptick in the number of newly enacted licensure compacts has come as result of support from both sides of the aisle. The rise in these compacts, which establish mutual agreement between member states for professional licensure, offer state legislatures an opportunity to safeguard state sovereignty while also ensuring the quality and safety of services. 

Since 2016, 290 pieces of licensure compact legislation have been enacted and, to date, 46 states, Washington, D.C., and three territories have enacted licensure compact legislation. A total of 15 professions currently have a compact available to states for enactment. In 2023, 57 pieces of compact legislation were enacted, with six new compacts becoming available for states to enact. 

The National Center for Interstate Compacts, housed within The Council of State Governments, played a role in the development of all active licensure compacts. Through the work of NCIC, as well as policymakers sponsoring compact-related legislation, licensees in compact member states can more quickly obtain authorization to practice and get to work in other member states. 

BIPARTISAN SUPPORT FOR WORKFORCE ADVANCEMENT

Compact legislation has experienced success in states with majorities from both sides of the aisle, while also having been sponsored by legislators from both parties. Support for state workforces proved to be a unifying theme among sponsors of 2023 compact legislation. 

Rep. Michelle Caldier, a Washington Republican elected into the House in 2014, was grateful for the bipartisan support she received when sponsoring the Dentist and Dental Hygienist Compact, which is recognized in Washington as HB 1576. Resolving workforce issues in the state, especially within health care, has been a priority. 

“I think trying to resolve Washington’s workforce issues is one of those things — across the board — that we acknowledge as one of the state’s goals,” Caldier said. “Breaking down the borders and allowing people from other states to come in and practice easily was one we could get a win on, so that was one of my focuses.” 

Bipartisan support led to the enactment of the Cosmetology Compact bill in Arizona, where the successful HB 2049 was sponsored by Republican Rep. Tim Dunn.

“This is a bipartisan bill that promotes the flexibility for stylists to move between states,” Dunn said. “Arizona has a lot of winter visitors, and this could provide work for them when they visit.” 

In Indiana, Democratic Sen. J.D. Ford coauthored both SB 251 ‚ the Interstate Medical Licensure Compact, and SB 160, the Counseling Compact. In addition to highlighting the bipartisan sponsorship of these bills, he explained ways in which he collaborated with his counterparts in the Indiana General Assembly to learn about and address community health needs. 

“Access to care isn’t a partisan issue, it impacts all communities,” Ford said. “I think we were able to really come together well in that common goal with these compact bills.”

MILITARY FAMILY BENEFITS

Legislators often mention how compacts break down barriers for military families who move frequently and face challenges working in a licensed profession. Without a licensure compact, both military members and their spouses must navigate each state’s process for licensure. 

Nebraska Sen. Carol Blood, a Democrat motivated to sponsor several compacts, believes they offer many benefits and opportunities to military families. 

“Interstate compacts benefit others in specific licensure areas, but the reason I started working with these compacts is because of our military families,” Blood said. “Military families tend to move every two to three years, which means new schools, new doctors, new homes and more. This is one less headache for these families to deal with.”

Due to the increased military support, the Department of Defense facilitated the development of interstate compacts as a mechanism for ensuring the portability of professional licenses for military spouses. In September 2020, the Department of Defense entered into a cooperative agreement with CSG to fund the creation of new interstate compacts designed to strengthen licensure portability. 

“[Compacts] are very positive for military partners who move to our state and people who are moving out of active service but want to continue working in a field where they are already licensed in another compact state,” said Colorado Rep. Mary Young. 

PROFESSIONAL PERSPECTIVES

Many sponsors of compact legislation were licensed professionals themselves. The sponsors of Colorado HB 23-1064, the Interstate Teacher Mobility Compact, worked in the field of education and understand the barriers teachers face. 

Young, a Democrat and former special education teacher and school psychologist, noted having her own experience with barriers to licensure as a teacher upon moving to Colorado. She admired efficiency and ease that compacts brought to licensure and wanted teachers moving to Colorado to remain in the profession. 

“With the Interstate Teacher Mobility Compact, we can ensure that teachers who want to come to Colorado can do so,” said Colorado Rep. Meghan Lukens, a Democrat and former social studies teacher. “Giving teachers 

the flexibility to live and work in any state in the compact benefits everyone. This compact will help incentivize teachers to stay teachers because of the flexibility that is provided to move to other states.” 

As a former dentist, Caldier, like Lukens and Young, was also familiar with the compact profession she sponsored. She also recognized the need for license mobility and the need to address the shortage of dental hygienists in Washington. Although she continues to support the field of dentistry, Caldier’s support of compacts extends to other professions as a cosponsor on the Counseling Compact, the Nurse Licensure Compact and the Occupational Therapy Compact.

Licensure Compact Enactments by State and Territory 
TELEHEALTH

Licensure compacts for health care professions can bring an added benefit to states: access to telehealth services. Ford said that compacts can “provide us with the opportunity to have more providers move to Indiana, but also greatly expand telehealth opportunities when you can meet with specialists in other states.” 

Much of the general population can benefit from the increase in telehealth that compacts present. Communities that do not have access to health care providers, as well as people with low mobility due to a lack of public transportation or low accessibility, can all benefit from a rise in telehealth. 

Of the 15 available licensure compacts, Audiology and Speech-Language Pathology, Psychology Interjurisdictional Compact, Counseling, Occupational Therapy and Social Work include provisions specific to telehealth. 

Blood offered the example of Nebraska LB 1034, the Psychology Compact, as psychology is a licensed profession. If a patient moves or travels to a different state than where their psychologist is licensed, their care can be stalled or halted. 

“Prior to that compact, Nebraska psychologists could not legally counsel someone over the phone if they were to have a mental health crisis in another state because that psychologist would not be licensed in that state,” Blood said. “With the compact, if the psychologist belongs [to the compact] as well as the state the patient is calling from, that psychologist can provide care for their patient.” 

With the rise of telehealth and telemedicine, compacts are an important tool to meet the needs of patients. As more states join compacts, the pool of providers grows, and patients access to care expands. 

OPPORTUNITIES FOR INCREASED STATE INVOLVEMENT

Legislators developed key takeaways throughout the process of introducing and enacting compact legislation. Attending informative events, involving key stakeholders, and working with colleagues from all parties enabled success. 

Several legislators noted how collaborative convenings, such as the CSG National Conference, are useful for learning from other leaders who have sponsored compact legislation. At the 2022 CSG National Conference, Caldier learned about the Dentist and Dental Hygienist Compact while Kansas Sen. Pat Pettey was impressed by discussion on the Teacher Compact. 

Pettey, a Democrat, and Washington Republican Sen. Ron Muzzall both suggest involving others, including other legislators and members of boards and professional associations. 

“Engage stakeholders on an individual basis and engage with Department of Defense and organizations dedicated to supporting military spouses,” said Muzzall, who introduced Washington SB 5219, the Counseling Compact. 

As the sponsor for Kansas SB 66, the Interstate Teacher Mobility Compact, Pettey recommended looking at compacts with an open mind. 

“Take note of compacts your state may already be involved in,” Pettey said. “Make sure that you talk to other legislators on either side of the aisle about the legislation that you are considering introducing, as well as talking to your state board of education and your teachers’ associations. Doing early work to make contact with other parties will be helpful for when they actually introduce [legislation].” 

More information on compacts can be found at the following website: compacts.csg.org. Policymakers interested in sponsoring a licensure compact can reach the National Center for Interstate Compacts via email at [email protected]. 

Educators to Executives: Education ‘at the core’ of Executive Officials’ Public Service

By Maggie Mixer and Abeer Sikder

Across the country, from Kentucky to Wisconsin to New Mexico, educators have been elected to the highest executive offices in their states. While their careers as teachers, coaches and administrators have taken different paths, they have all been driven by a commitment to serving their communities and future generations. Education, for them, is the cornerstone and catalyst of their public service.

Serving the State by Serving Youth
Wisconsin Gov. Tony Evers started as a teacher before climbing the educational administration ladder, advancing positions that ranged from principal to state superintendent. After his three terms at the helm of the Department of Public Instruction, which manages all of Wisconsin’s public education systems, he was elected as governor on a platform that put education front and center.

“What’s best for our kids is best for our state.”

— Wisconsin Gov. Tony Evers

Throughout Evers’ career in education administration and elected office, he has been driven by his goal to ensure that the education system “had the resources they needed” to set Wisconsin’s students on the path to success. His favorite adage — “what’s best for our kids is best for our state” — is a slogan he joked his longtime supporters are tired of hearing, yet he said it still rings true and has served as a guide stone during his career.

“Public education is still at the core of my being and it continues to be. I get in front of schools as much as possible,” Evers said. “What I learn on a daily basis is the most important thing is to get out and talk to people, ask them what they need, what they’re irritated about, how we can help.”

Regardless of who he is talking to around Wisconsin, Evers always asks them about the kids in their life and what the state can do to improve the education system. Despite all possible differences in policy discussions, he still sees the unifying power of education. This approach has served Evers well as he coordinates with his state agencies, the state Legislature, community organizations and constituent groups across the state to create a better future for Wisconsin.

“Whether you’re in front of a classroom of kids that come from any kind of background you can imagine, to working with parents and school boards, the ability to bring people together and accomplish things is critically important,” Evers said.

This year, concerned about the crises he was “seeing in every part of the state,” Evers declared 2023 the “Year of Mental Health in Wisconsin” and directed his administration’s resources towards strengthening the mental health support systems available throughout the state. Through negotiations with the Wisconsin Legislature, he secured $30 million in the most recent budget for school mental health programs.

The Accidental Advocate
Kentucky Lt. Gov. Jacqueline Coleman has also prioritized student mental health during her term. An educator for more than a decade, she first served as a teacher before later becoming an assistant principal. During that time, according to Coleman, she became an “accidental advocate,” choosing to teach social studies and civics because “there were so many young people that didn’t understand how government should work and their role in ensuring that it does work.”

Although Coleman loved her time as an educator, “the lack of resources, the lack of funding, the attacks on teachers … were all things that really drew [her] to more of the advocacy arena.”

“With every challenge that we face in Kentucky, the solution — or at least part of the solution — is education. I see [every challenge] through the eyes of the kids in our classrooms and the families that I got to work with every single day as a teacher.”

— Kentucky Lt. Gov. Jacqueline Coleman

In 2021, Coleman launched the Team Kentucky Student Mental Health Initiative. She said schools are “microcosms” of the communities that make up Kentucky, which is why it is so crucial to include the perspectives of teachers and students in the legislative process.

As part of the initiative, Coleman’s office held 10 regional summits where students facilitated conversations with their peers and used that information to create policy recommendations. These recommendations became the “North Star” of the administration’s efforts after they were presented to the Legislature, state agencies and community partners. Coleman credited the initiative with helping her secure $40 million in federal funding to support Kentucky’s mental health care workforce and strengthen mental health services in schools.

An educator and “lifelong learner,” Coleman’s recent work pushed her to also extend her own education on student mental health. She is currently pursuing her doctorate in educational leadership from the University of Kentucky and plans to focus her dissertation on the topic.

Special Education and Service
Educators’ focus on building a better future has been crucial for pushing policy forward, especially in the face of serious setbacks. After teaching special education for 10 years, New Mexico Lt. Gov. Howie Morales served in the state Senate for 11 years before taking office as lieutenant governor.

In the Senate, Morales proposed the creation of an Early Childhood Education and Care Department to organize New Mexico’s support structures for early childhood development. The bill failed to pass, but he continued working and was able to oversee the department’s creation during the beginning of his term as lieutenant governor.

Morales’ effort was part of his long-term goal to improve not only K-12 and higher education opportunities, but also New Mexico’s programs and services around early childhood, extracurricular and adult education, so that all New Mexicans can receive a quality education.

“Being a special educator, I think it has really shown that it’s about the personalization of the educational process. I believe that we’ve focused all too often across the country on student proficiency or student achievement when, in reality, we should be focusing on student engagement.”

— New Mexico Lt. Gov. Howie Morales

Through Morales’ work, “a historic $20 million appropriation” was directed toward after-school programs that engage students “beyond the walls of a classroom.” Known as the General Appropriate Act of 2023, New Mexico HB 2 was signed into law in April.

Morales’ goal for more personalized education comes from both personal and professional experiences as the first member of his family to attend college and graduate school. From a young age, as a member of student council, he was committed to his “responsibility” to ensure that the students after him had access to the educational path that transformed his life. His experiences and family also instilled in him the idea that “leadership is about service … it’s not about a position, it’s about action.”

“I left the classroom to make a difference in policy,” Morales said. “Above all, what I love more than anything is to interact with people … to be there shaking hands, to be accessible, be respectful and always have the opportunity to create those relationships.”

CSG Travels Abroad to Expand Apprenticeship Education

By Trey Delida

Last week, CSG staff and members attended the 2023 Transatlantic Apprenticeship Study Trip in Germany. From Stuttgart to Munich, Bayreuth to Berlin, attendees saw firsthand how well-developed apprenticeship programs impact communities.

Hosted by DIAG USA, a nonprofit that gathers stakeholders based on the example of German apprenticeship programming, the goal was to show how one country successfully implements apprenticeships.

Other organizations from the United States included the Urban Institute, the Colorado Office of Apprenticeship, the Workforce Development Board system in California, members of the Pennsylvania Senate and more.

As states face workforce shortages across sectors, apprenticeships could be a viable solution in expanding work-based learning and upskilling workers.

“As rapidly changing technology is revolutionizing the way we work, we are on the forefront of preparing our partners for this transformation,” DAIG USA posted on its LinkedIn. “Many companies are looking for a sustainable pipeline of talent that more effectively supports their goals for growth and profitability. We believe that Apprenticeship programs offer an innovative and win/win solution.”

The trip included visits to German businesses, government offices, schools and the German Chamber of Commerce, all of which utilize apprenticeships as a career pathway.

CSG has partnered with DIAG USA for several years. Center of Innovation Deputy Director of National Programs Sydney Blodgett shared that the trip allowed attendees to learn about the established German apprenticeship system firsthand.

“We visited the different stakeholders involved in workforce development and learned how they encourage folks to get into different career pathways and all the different entry and exit points,” Blodgett said. “We’ve worked with them for a couple of years now, and as apprenticeships are growing in the US, people are looking at alternative pathways to careers as the student debt crisis grows in the U.S., people are really looking at other ways to get into careers.”

CSG works extensively with several organizations and stakeholders on the expansion of apprenticeships in the United States.

For more information on CSG’s work to improve access to apprenticeships, click here.

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

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.”

Spreading the Word about Evaluations

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.

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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 43 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.