Following Legislation Trends

State policymakers offer unique, viable solutions to common issues in 2023

By Lexington Souers

Legislatures in 2023 have introduced or pre-filed more than 97,000 bills, resolutions and memorials. Of those, at least 14,000 were enacted into law by June, ranging from workforce development to pass-through entity taxes. 

WORKFORCE DEVELOPMENT
Once COVID-19’s societal impact subsided, states attempted to remedy workforce concerns by passing legislation on sector specific programs, regional development plans and interstate compacts. In 2023, more than 30 bills on interstate compacts have been enacted in more than 15 states. 

The Kansas Legislature enacted HB 2288, enabling mental health professionals to join the multistate Counseling Compact. Rep. Susan Ruiz, who helped pass the bill, said its success is a win-win for providers, patients and Kansans. Ruiz is the ranking member of the Health and Human Services Committee and a licensed clinical social worker.

“This is a very bipartisan effort to enhance our workforce,” Ruiz said. “We have put a lot of funding into enhancing our mental health services across the board, but we need the practitioners involved to bring all that to fruition. So, anything that we could do to enhance our workforce, we did it.”

Ruiz said HB 2288 allows practitioners licensed in another state to practice in states that are members of the compact. Practitioners must maintain their licensure, undergo a background check and complete other requirements. Due to these safety measures, patients can feel confident in a provider and protect their continuity of care, which Ruiz said could be “devastating” if interrupted. 

Almost every bill on workforce training was passed, leading 24 states to pass more than 85 bills. Minimum wage bills were enacted in five states and 15 unemployment bills passed in four separate states. 

ELECTIONS 
By June, legislators filed more than 1,700 bills relating to elections. Of those, 119 were enacted across 28 states. While the focus of legislation varied, many bills enhanced protections for election officials. It’s those workers who help “operationalize democracy,” according to former election official Veronica Degraffenreid, senior manager of strategic partnerships, elections and government at the Brennan Center for Justice.

Degraffenreid said the Brennan Center completed three surveys, the most recent of which notes that one in three election officials have been abused, harassed or threatened, with three in four seeing an increase in threats.

“What I believe policymakers and lawmakers are doing is a pragmatic approach. They’re like ‘let’s do something and address it,’ but understand that along with the pragmatism is a passion that these are people in our communities. They are our friends. They are our neighbors. We go to school with them and to religious services with them or ballgames. It’s their job to carry out the work and carry out their responsibilities. It’s absolutely something that we need to do, but we should want to do it, and want to make sure that we protect the lives and the livelihood of these American citizens.” 

— Veronica Degraffenreid, senior manager of strategic partnerships, elections and government at the Brennan Center for Justice.

Legislation protecting election officials generally follows three paths that potentially result in increased funding, mounting criminal penalties for perpetrators, and/or additional information protection. Funding adds to the physical safety of election offices and polling places. Legislation surrounding doxing prevention and implementing address protection programs allows for increased physical safety and prevents malicious action against an election administrator or poll worker. 

“If we want voters, however they participate, to have faith and confidence in the process and the people who are performing those duties, we want election administrators to be focused on conducting fair, accurate and safe elections; we want them to do their duty, their job that is dictated by federal and state law.” 

TELEHEALTH 
Originally designed to provide health care access to rural and underserved areas, telehealth is now in widespread use. However, the popularity of telehealth, especially following its use in 2020, highlighted a need for increased regulation. Legislation in 2023 expanded existing framework to allow out-of-state providers to work with a certain state’s patients, increases prescribing ability for certain drugs and payment parity for services. Multistate legislation could be helpful in allowing providers to uphold state specific licensure requirements, meaning patients have a wider range of care. 

Across 22 states, 44 telehealth bills were enacted this year entering June. These bills expanded funding and access to telehealth. Virginia SB 1418, which passed on March 21, permits telehealth entities with state licensed health care providers do not need to maintain an instate address to enroll as a vendor or provider group under Medicaid. The bill also allows health care providers to not maintain a physical presence in the Commonwealth to enroll as a Medicare provider. 

“This is a bill with a significant impact on access to quality health care for Virginians, especially those in rural areas like southwest Virginia, which I represent,” said Virginia Sen. Todd Pillion. “In short, it fixes a systemic problem in Medicaid enrollment for Virginia-licensed providers. Prior to this bill, a Virginia licensed provider or provider group must have a physical address in Virginia in order to enroll in the Medicaid program.”

This allows licensed providers who do not have a physical Virginia address to aid patients. At the same time, patients can know the care they are receiving meets state licensing standards and other Medicaid qualifications. Pillion said the legislation reduces regulatory burdens and allows Medicaid to “leverage telemedicine” to better serve both providers and patients. 

“The more we can do to reduce regulatory burdens and enhance quality of life, while increasing health care options, is a win for patients, providers and rural communities.”

— Sen. Todd Pillion, Virginia

INSULIN 
More than 29 bills filed in 23 states were aimed at capping the cost of insulin and other diabetes care-related supplies. Despite recent federal caps, many Americans with diabetes still face high annual insulin costs. In response, states and private companies are capping costs in specific circumstances.

Insulin is relatively easy to produce, given its chemical makeup, but patients are often paying at least four times the amount those in other countries do. Additionally, the cost of pumps and other supplies are often not covered under a cap.

In North Dakota, Sen. Tim Mathern introduced SB 2140 to cap monthly copays at $25 for insulin drugs and supplies for health insurance programs. Mathern said the bill went through several iterations in both house and senate committees.

“The challenge is never-ending — to create a world where each and every person has the right to affordable, accessible and quality health care,” Mathern said. “SB 2140 is one small step toward that goal which I have been working on in the senate since 1986.”

Mathern suggested connecting with families experiencing diabetes and federal advocates to explain the importance of capping insulin costs. As well, he suggested increased education on the issue, especially because of an existing federal cap. 

“A challenge in the drafting was identifying what specific items were to be covered by the $25 cap,” Mathern said. “I also found, as a democrat in a red state, it was a great boost to have republican cosponsors.”

CAREER AND TECHNICAL EDUCATION 
Career and technical education, or CTE, is defined in the Strengthening Career and Technical Education for the 21st Century Act of 2018 as a series of courses that prepares students for futures in technical skills or industries, works to solve the skills gap. Studies show that involvement in CTE leads to higher wages, especially after the completion of advanced coursework. Spreading awareness of these programs and knowledge of the typical CTE student helps increase program success. In addition, integrating CTE courses into high school curriculum provides a benefit for students who may have chosen other classes to meet strict graduation requirements.

High school career and technical education courses prepare students for entry into the workforce by offering hard and soft skills specific to an industry. Students can use these skills immediately after graduation or in postsecondary training. States report that high school students taking at least two CTE courses have a 95% graduation rate. CTE programs provide skilled employees in professions facing labor shortages.

In 2023, 23 bills concerning career and technical education were enacted. At least eight states passed legislation allowing CTE courses to count as high school credit or meet a graduation requirement. Six states — Colorado, Georgia, Hawaii, Idaho, Kansas and Washington — passed general legislation concerning career and technical education, including pilot programs for nurses and joint studies on high school program enrollment.

PASS-THROUGH ENTITY 
This year, seven states joined 28 others with pass-through entity taxes, according to the American Institute of Certified Public Accountants. An additional two states have also proposed legislation. A partnership, such as an LLC, can elect to pay state and local taxes at the entity level, rather than having those costs “pass through” to the owners. This offers the owner a federal income tax credit to reduce their personal federal income tax. Due to disparities in state taxes, some state residents paid more than others in federal income taxes despite similar incomes. By passing legislation allowing pass through taxes, states can balance the cost of taxes on some citizens.

“We think this will help our West Virginia small businesses that are organized as pass-through entities decrease the amount that owners would have to pay in federal income tax,” said West Virginia Sen. Mike Oliverio, who sponsored SB 151. “In turn, we’re hopeful that will enable them to invest more money into their business, pay more money to their staff, or simply enjoy more the dollars that they’ve earned from their business.”

Oliverio said states have taken various approaches to legislating pass-through taxes, and given that the federal government was not preventing states from passing legislation, he and other West Virginia legislators wanted businesses to have the same benefits as other states. 

“At some point, there has to be a balancing of what each of you respectively pay to the federal government in taxes as well,” Oliverio said. “The citizen in West Virginia versus the citizen in [a high tax state] is enjoying the same benefits of the CDC, the United States Army, the Postal Service and all those federal agencies that they’re funding with their taxes.” 

Presiding Over Party Lines

Relationships, respect integral to Rep. Tilton as Alaska’s House speaker 

By Lexington Souers

Alaska Rep. Cathy Tilton served as House minority leader from 2021-22 before being elected as speaker of the House in 2023. As speaker, she directs the chamber’s legislative process, upholds bipartisanship and appoints committee membership. Tilton’s focus in that capacity is on building respect within the chamber and improving Alaska’s financial stability. 

Prior to joining the Alaska State Legislature, Tilton enjoyed a long history in public service. Her 33-year career features work with both the Legislature and mayor’s office in Wasilla, Alaska. First elected in 2014, Tilton chaired the House Community & Regional Affairs Committee as a freshman legislator. She has since served on the House Finance and Rules Committees, among others. 

What sets Alaska’s coalition apart from other state legislatures? 
Tilton: In the past several elections, this electorate has elected people into office where it’s been really divided — for the House, especially. It could be even on a 20/20 divide if you’re looking at partisan membership. That’s been a hard thing to overcome. One of the key things, I think, to keeping this chamber a working chamber is to show that respect for yourself while also having respect for others. I want to bring respect back to the institution overall. Alaskans want us to get our jobs done. We have this partisan divide that, over the years, has become wider and wider. I recognize that we really need to stay true to our beliefs, our morals, our values, our constituency, but we can do that in a respectful manner where we can agree to disagree. 

As speaker of the House, how do you approach bipartisan issues? 
Tilton: Way back when I was in my first session as a legislator, I chaired the House Community and Regional Affairs Committee, which is really about all of Alaska. Let’s face it, I was raised on the Railbelt, in south central Alaska. I hadn’t really traveled my own state very much. It was a really good experience for me to be on that committee to learn to balance the needs of my area with the needs of rural Alaska, and to take bills and bring those together in a collaboration so that that they were acceptable to both areas. That’s the way I’m approaching this as a speaker. We have to be conscientious of the needs of our entire caucus.

What unique challenges does Alaska face? 
Tilton: The big issues that we’re dealing with are the volatility of our income and revenues. We are an oil revenue state, and, of course, we all know what the volatility of oil. Then there’s the tension between the permanent fund dividend, which is different than a lot of states have. There’s a little bit of tension between the dividend going to the people and public and government services. Where does that all fit in in our budget? We have a lot of tension in our own caucus, in this entire building and for the entire Legislature. 

What experiences outside of the Legislature helped you become the leader that you are? 
Tilton: I started out working at a law firm as a legal secretary, which I think gave me a little bit of background in some law. Then, for 10 years, I worked in local government. I worked for five mayors of Wasilla. That’s a lot of different types of leadership that I adjusted to. Before I ran for office, I was running my own business and taking care of my family. When you’re paying your own payroll and taking care of others, it’s a different perspective. 

I stick to my values of who I am and what my constituency believes in. I’m from a really red part of Alaska. I’m very conservative. That being said, I do believe in fair treatment for everybody. I look at the fact that I am a leader of leaders. My role as the leader of leaders is to lift other leaders up and help them to become a leader. I won’t be here forever. I don’t expect to be. I feel like my role is to help them move into leadership spots. 

What do you see for the future of Alaska? 
Tilton: I would love to see us be able to come together on some sort of a fiscal plan. It’s going to be difficult. Obviously, the Legislature has been working on it for 20 years and haven’t gotten there yet. But I think that we’re at that point in Alaska where we don’t have a choice. We really have to do something here to stabilize Alaska. 

The second thing I think I would like to see really worked on is high crime issues. There are a series of crime bill dealing with fentanyl, sex trafficking and those kinds of things. I think it’s important to Alaskans that we do something about those things, and I’m hoping that we can all work together to get those over the line. 

Do you have any favorite memories from serving in the Alaska State Legislature? 
Tilton: I was a private business owner and stayed home with my kids before I went to work at the Legislature. I really didn’t plan to run for office. Some of my favorite memories are from some of the relationships that I have built here that are uncommon. I was a minority leader last session and the minority leader for the Senate was Sen. Tom Begich. I feel like he and I — although on total opposite sides of the aisle — built a relationship and were able to work together to meet the needs of the minorities. I think that’s one memory. I don’t know that if you were out in the real world that you would have that opportunity to build a relationship, and what I would call a true friendship, with somebody who was on the other side of the aisle from you. I think I look at that as being one of the accomplishments from being here that I hold very dear. Relationships are really important to me. 

Emerging State Responses to Homelessness

Increased funding, innovative strategies intend to offer resolve

By Cody Porter and Jennifer Horton

Homelessness in the United States trended upward ahead of the COVID-19 pandemic. An already dire situation neared critical levels as the economic downturn forced countless businesses to close and unemployment rates to surge.

The nationwide poverty rate in 2020 climbed by 3.3 million, increasing the total number of individuals living in poverty to 37.2 million people, or 11.4% of the population. With necessities like housing being less affordable due to soaring home prices, homeless numbers also grew.

As of January 2022, an estimated 582,462 individuals experienced homelessness in the U.S., according to the National Alliance to End Homelessness. Rates of homelessness vary widely across the states. Per capita, Washington, D.C., California, Vermont, Oregon and Hawaii have the highest rates of homelessness.

State legislators take a range of approaches to address the nuances linked to homelessness, including efforts focused around affordable housing, transitional housing, and programs like Housing First that reduce prerequisites involved in the buying or renting processes.

— Wayne Niederhauser, Utah homeless coordinator

Utah Gov. Spencer Cox appointed former Senate President Wayne Niederhauser to the role of state homeless coordinator in April 2021. His appointment came on the heels of the Utah Legislature establishing the role in its pursuit of a strategic plan to reduce homelessness.

That strategic plan — the Statewide Collaboration for Change: Utah’s Plan to Address Homelessness — arrived in March, a year after the Utah Department of Workforce Services revealed a 14% increase in the number of Utahns experiencing first-time homelessness. Response efforts included within the plan include a five-goal strategy centered around increasing opportunities for accessible and affordable permanent housing, support services and case management, homeless prevention strategies, and housing resources and services for the unsheltered.

In September 2022, Salt Lake County, Utah, received $30.2 million from the state for new affordable housing. The funds were part of a broader $55 million statewide investment via American Rescue Plan Act funding for the construction of 1,078 affordable to deeply affordable housing units. Access to deeply affordable housing is for those who annually earn less than $25,000.

“We now have the opportunity to increase deeply affordable housing, which is the hardest housing to provide,” Niederhauser said. “That’s focused on homelessness and workers who really are [earning] $15-20 per hour and got to have deeply affordable housing.”

Salt Lake City’s 40-acre Other Side Village is among the first developments to come from the ARPA funding in 2022. Ground broke in March for the tiny home village, which is expected to house 60 individuals experiencing homelessness. The plan is to further develop the lot to offer sufficient housing for as many as 400 individuals.

“Deeply affordable housing requires additional help — [more than just] low-income housing tax credits,” Niederauer said. “The project needs to be sustainable and it’s not sustainable if it doesn’t have enough cash flow.”

In total, more than $200 million was appropriated by the Utah Legislature for affordable housing and homelessness initiatives prior to concluding the 2023 session. According to Niederhauser, legislative successes include $50 million in deeply affordable housing funding; a low-income housing tax credit worth nearly $60 million; housing stabilization grants, including project based rent support, accompanied by $5 million in funding; a statewide code blue system; a request for a response plan for larger counties; and $12 million for homeless services.

Between 2005-15, Utah was a prime example of how to curb homelessness through its use of the Housing First model. The state reported reducing its homeless population by 91% throughout the decade, although that number has decreased since 2015.

Housing First is an evidence-based approach to ending homelessness that provides people with immediate access to housing and support services without preconditions. Based on the belief that people need to have their basic needs met before addressing other issues like employment or substance abuse, the Housing First model emphasizes client self-determination within a trauma-informed, harm-reduction framework. The model has been successful when applied to a range of circumstances, including both families who became homeless due to a temporary crisis and chronically homeless individuals.

There are two common models that utilize the Housing First approach depending on a person’s needs and whether they need long or short-term assistance. The permanent supportive housing model provides long-term rental assistance and supportive services to individuals with chronic illnesses, disabilities, mental health issues or substance use disorder who have experienced long-term or repeated homelessness. A second model, known as rapid re-housing, provides short-term rental assistance and services to help people obtain housing quickly and increase self-sufficiency so they can remain housed.

The Maine Legislature’s Committee on Housing hosted Niederhauser in March to learn more about Utah’s successes and failures with the Housing First model.

“I testified in their committee because they wanted to know what happened in Utah. The fact is we didn’t keep up. That’s the bottom line,” Niederhauser said. “You need to provide housing, but you also need to provide more as your population grows … and you have got to have deeply affordable housing to address homelessness. You can’t be satisfied with what you’ve done in the past. It has to be an ongoing effort.”

Maine ranked eighth per capita for homelessness in 2022, according to data compiled by the National Alliance to End Homelessness. And from 2021-22, Maine’s homeless population increased by 113.8%, according to U.S. Department of Housing and Urban Development.

“[Housing First] is an initiative that really is transformational,” said Ryan Fecteau, senior advisor of community development and strategic initiatives for the Maine Governor’s Office of Policy Innovation and the Future. “It’s probably the most transformational policy around homelessness in Maine history and will be a huge step forward in addressing that.”

Housing First was included in by the recently proposed budget of by Maine Gov. Janet Mills. If adopted, the program, contained in Speaker Talbot Ross’ proposed LD 2, would be established within the Maine Department of Health and Human Service.

An estimated 450 chronically homeless Mainers currently live throughout three Housing First model properties in Portland. Ninety efficiency apartments were constructed by nonprofits Avesta Housing and Preble Street in 2005, 2010 and 2017.

“Our service center communities, particularly Bangor and Portland — our two largest cities — are shouldering this challenge in a big way because a lot of people seek services in the city,” Fecteau said. “[While those seeking shelter] might not necessarily be from Portland or from Bangor, they end up there as a means of seeking services from the cities. Getting people stabilized affordable housing is a challenge across the spectrum. Whether it be folks who are experiencing homelessness or folks who are currently housed, they are having to pay way more than they should have to with their annual incomes.”

Fecteau added that Gov. Mills’ proposed budget also offers $12 million in one-time funds for the Emergency Housing Relief Fund. Those funds could continue supporting efforts to assist individuals and families experiencing homelessness. In addition, the Legislature included a $21 million emergency spending package in January supporting emergency housing and shelter.

Research indicates people assisted through the Housing First model access housing faster and are more likely to remain housed, with studies showing a one-year housing retention rate ranging from 75-98%. The approach tends to be cost-efficient, generating savings through reduced usage of emergency services, hospitals, jails and emergency shelters.

Shifting Skills: Labor Shortages Drive State Changes to Education, Employment Requirements 

By Grace Harrison

For government leaders at the state and national levels, some of the most important metrics of their success in office are economic conditions, such as unemployment levels or job growth. Market conditions and workforce characteristics are often determined by macro-level circumstances, though, and are beyond the control of a single U.S. representative or governor. Despite trends toward an increasingly educated workforce, states still face labor shortages. Governors in Alaska, Colorado, Maryland, New Jersey, North Carolina, Pennsylvania and Utah are advocating for changes in education and skill requirements to bridge this gap.

EDUCATIONAL ATTAINMENT OVER TIME
Since the mid-20th century, the number of workers with a postsecondary degree has increased significantly. For workers aged 25 and older, the proportion of those with a higher education degree increased by around 30 percentage points from 1960 to 2021. As the education level of the U.S. population has increased, researchers have begun to question how educational attainment, income and unemployment are interrelated.

In 2014, Pew Research Center published a report detailing the “rising costs of not going to college” for millennials. Combining Pew and U.S. Census Bureau data, the report highlights three areas of disparity based on levels of educational attainment — annual earnings, unemployment rates and the share of individuals living in poverty. Though there have been differences in the earnings and general economic outcomes of college and high school graduates across generations, the annual income gap has increased from $7,449 in 1965 to $17,500 in 2013.

Underlying this trend is the general divergence of earnings, indicating rising median earnings of college graduates coupled with falling median earnings of high school graduates.

THE CURRENT STATE OF THE LABOR MARKET
Despite fluctuations throughout COVID-19, the economy stabilized to a point where analysts can determine the current state of employment for various demographics. There was a 13.6% decrease in employment during the first month of the pandemic, which is the largest one-month decrease since 1939. Since then, employment fluctuated across sectors as overall economic growth remained volatile. Now, three years later, in the context of interest rate hikes and contractionary spending, the labor market faces the opposite problem: rapid growth in job postings, with not enough applicants to fill open roles.

In January 2023, employers created 517,000 jobs. Economists want to know why, despite low unemployment levels and the increasing population of highly educated workers, labor force participation is around one percentage point lower than pre-pandemic rates. A working paper from the National Bureau of Economic Research found this trend is due to “less hours worked” rather than “less workers.” Males aged 25-55 with bachelor’s degrees experienced the greatest decrease in work hours. Exactly why this voluntary decline in hours worked took place is undetermined, but authors suggest a desire to create a better work-life balance could explain this trend, which, if true, will have further implications for societal roles and future efforts to curb unemployment.

Similar research offers an alternative explanation as to why open roles continue to go unfilled. The relationship between higher education and higher wages is a primary factor, particularly in fields like retail and health care.

“As long as the benefits of obtaining a college degree exceed the cost for an increasing number of Americans, we should expect to see the number of Americans with a college degree continue to steadily climb."

— Kory Kantenga, LinkedIn senior economist, to S&P Global

People who would traditionally fill low-wage positions are pursuing higher education and increased wages or otherwise seeking more competitive employment. This trend could shift if employers modify their hiring practices and requirements. For instance, skill-based assessments, rather than degree requirements, might slow the growth of individuals pursuing higher education. Governors across the U.S. supported replacing degree requirements with skills and experience assessments.

EXECUTIVE ACTIONS TO ADDRESS LABOR SHORTAGES
Public sector employment, responsible for government and public services such as education and transportation, faced some of the largest labor shortages in the last few years. Despite the increased demand for public services due to growth and infrastructure investment, state and local governments struggle to attract college graduates to fill these crucial positions. Competitive employment, as well as job and social mobility, are not typically characteristics of state and local government employment, despite the offerings of stable income and benefits.

The need to fill these public sector positions, combined with efforts of workforce development across states, has recently led governors to remove degree requirements — typically a bachelor’s degree — for government jobs.

Maryland Gov. Larry Hogan announced in March 2022 a “first in the nation” program to strengthen the state’s workforce. It was determined that more than half of the nearly 40,000 state jobs did not require four-year degrees, but rather relevant skills, work experience or community college education.

In April 2022, Colorado Gov. Jared Polis signed an executive order “directing state agencies to consider job applicants skills and experiences as substitutions for educational degrees.” On Pennsylvania Gov. Josh Shapiro’s first day in office, a similar executive order was passed.

Other governors implementing similar skills-based hiring practices within the past year include Alaska Gov. Mike Dunleavy, New Jersey Gov. Phil Murphy, North Carolina Gov. Roy Cooper and Utah Gov. Spencer Cox.

Implications of these Practices
This advancement in employment accessibility and development has now extended past executive actions. In the first few months of 2023, the Georgia Senate proposed and passed SB 3, the Reducing Barriers to State Employment Act of 2023. To date, eight states reduced the requirements of public sector employment, serving as examples for other states looking to do the same.

Because it is still early on in this transition, concrete impacts are yet to be determined. However, predictions for the future of educational attainment and state workforces are becoming clear. Employment expansion to skilled individuals without a degree provides economic stability and growth to not only the state and its constituents, but those individuals now receiving salaries and benefits that were previously unattainable.

Skills-based hiring practices and newly-created state programs also benefit individuals with disabilities, who often face higher barriers to education and employment. Though the steady increase in individuals obtaining postsecondary degrees likely will not disappear, state governments are making strides in promoting employment accessibility and combatting labor shortages.

Federal Law on Licensure Barriers for Military Spouses Prompts Concerns from States

By Cooper Smith

President Joe Biden signed the Veterans Auto and Education Improvement Act of 2022 (VAEIA) on Jan. 5, 2023, which includes provisions that support military service members, from educational assistance benefits to automobile allowances. Section 19 of the Act intends to help service members and their spouses easily obtain professional licenses when they relocate to another state due to military orders.

Though Section 19 is well-intentioned, it bypasses the principles of federalism while placing an incomplete, unfunded federal mandate on states — and it overlooks the many ways that states have crafted, and continue to craft, policies that address barriers that military service members and their families face during a change of station.

Section 19 Encroaches on State Sovereignty
The Tenth Amendment reserves the authority to regulate and license these local matters for the states. States — not the federal government — have the responsibility to issue occupational licensing standards as part of the power to protect public health and safety. Section 19 of the VAEIA interferes with states’ jurisdiction to regulate the health, safety and welfare of their residents, and it is counter to America’s federalist system.

Beyond state sovereignty concerns, state policymakers and regulators view the process described in Section 19 as unworkable. The section states that a license “shall be considered valid at a similar scope of practice and in the discipline applied for.” Despite this, the text provides little further guidance, creating significant issues in professions where the scope of practices varies across states.

Terminology like “similar scope of practice” is ambiguous and could be confusing if the service member or spouse’s license has a different scope of practice. If the state a practitioner was previously licensed in did not allow them to perform certain procedures, but the new state does, questions could arise as to the licensee’s competence when that practitioner has never been licensed to perform the procedure.

The language confounds licensure with certification. There are professions where some states require a license, whereas other states allow voluntary certification. It appears that a service member or spouse could practice in the state they’re relocating to if they hold a certification and not a license. State boards could now be required to license practitioners with a voluntary certification or practitioners would be eligible to practice in a state that requires licensure and comes with a higher standard of requirements that ensure competence.

A State-led, Cooperative Approach
States lead the way to provide relief on the issue of professional licensure for military spouses. Forty-nine states provide either expedited licensure, temporary licensure or endorsement for military spouses, alleviating barriers to employment caused by state regulatory structures. Forty-four states have passed legislation that includes language stating that a licensing body ‘shall issue’ an employment credential to a military spouse licensed in another state. Additionally, states passed more than 200 separate pieces of legislation directly pertaining to military spouse licensure portability.

Similarly, interstate occupational licensure compacts have a documented history of success in easing the relocation of military spouses. States have enacted more than 270 separate pieces of occupational licensure legislation since 2016. States demonstrated that they are well-equipped and motivated to deliver for service members and their families.

Within this state-led approach, the federal government can play a cooperative role instead of a commanding one. The Council of State Governments facilitated the development of language used in many of these occupational licensure compacts in cooperation with state regulators, professional organizations, licensed professionals and federal partners like the Departments of Defense and Labor to provide robust benefits for military spouses. These departments have partnered with the states to create a solution that protects state sovereignty while achieving employment and professional goals.

In the absence of federal mandates, states can work alongside federal agencies to make progress. Section 19 circumvents states’ cooperative approach. While the section exempts interstate occupational licensure compacts, the mandate has the potential to complicate the development and consideration of new compacts by burdening state resources and implying that existing state solutions are not optimal. If the states were ignoring this issue, Section 19 could have been appropriate. However, when states are passing legislation and banding together to deliver for service members and their families, there is no need for the federal government to vault over existing progress.

New Legislative Leaders Academy Unites Policymakers in Chicago for Development, Networking

By Trey Delida

Focusing on unity across the political divide, policymakers and CSG Associates from across the nation convened in Chicago June 14-16 to attend the New Legislative Leaders Academy.

The meeting, centered on leadership development and forging connections with fellow legislators, began with opening remarks from David Adkins, who serves as the CSG executive director/CEO, and introductions from attendees. Designed to be interactive, the academy encouraged guests to share concepts and ideas with each other while also achieving a better understanding of their personal strengths as state leaders.

Lorna Patches, who is the CSG deputy director of membership and leadership development, challenged attendees to reflect on their personal capabilities to maximize their skills as a leader.

“Hone in on your strengths and leverage them to be more effective in your role as a policymaker,” Patches said. “There is so much shared knowledge and passion for public service in this room, utilize this space to learn from others.”

Legislators joined roundtable discussions, panels with healthcare experts, communication workshops, interstate compacts, presentations and more. Each session prompted guests to reflect on personal experiences, share viewpoints and stimulate growth as a leader.

Much of the learning from this academy came from the dialogue between attendees, according to Kentucky Rep. Rachel Roberts.

“One of the things I really love about this program is that not only do you provide great speakers for us, but you give us time to sit and talk to our fellow lawmakers from other states where we can exchange best practices,” Roberts said.  “I’m grateful that inter-state collaboration was built into the curriculum.”

State leaders also joined a panel on “How New Legislative Leaders Can Be Effective in Divisive Times.” Adkins moderated the panel, which featured Nebraska Speaker John Arch,  Colorado Speaker Julie McCluskie, Wyoming Rep. Clark Stith and Hawaii Rep. Greggor Ilagan.

The panel discussion centered on the various approaches to issues that defy state lines, like health care policy, state funding and how to step into bipartisan leadership roles during times of political divide.

“It was really interesting to hear from other states how they deal with the divisive atmosphere in politics,” Stith said. “It’s good to feel that I’m not alone in dealing with the polarity of politics, so the emphasis on trying to achieve civility is really important.”

This academy was uniquely positioned to provide informative sessions with subject matter experts while also encouraging honest conversations among participants. Hawaii Rep. Troy Hashimoto said having frank discussions with other legislators “gives insight” that legislators can used in leading their own states.

“A lot of these sessions resonate with me,” Hashimoto said. “The finer details of how we operate as leaders is really important. Learning tactics from other states is one of the most powerful aspects of this seminar, knowing that they have similar issues. You can understand what has worked and was hasn’t.”

Benefits of State Paid Parental Leave Policies on Children, Parents

By Trisha Douin and Dr. Dakota Thomas

The United States currently has no federally mandated paid family leave policy. To fill this gap, 13 states and the District of Columbia have enacted their own paid family leave laws (see Map 1), while three others — Georgia, New Hampshire and South Carolina — offer paid parental leave exclusively to state employees.

Most of these state programs provide parental leave out of consideration for a new child, foster care or adoption while also providing leave options for family caregiving. Also included in most programs is temporary disability insurance to cover paid personal medical leave.

State policies vary in multiple dimensions, including costs, funding models, permitted duration of leave, eligibility requirements and impacts on parental child welfare. Depending on the specific funding model a state pursues, these policies can have little to no impact on the state budget. Research suggests that paid leave has positive impacts on child health and wellbeing, parental finances and parents’ mental health. Unpaid leave does not confer any of these benefits. 

Costs and Funding Models 
Although funding structures for paid leave policies vary, most states use a social insurance policy design that funds benefits through pooled payroll taxes on employees and/or employers. Others offer paid family leave through private insurance on a mandatory or voluntary basis.

In these systems, companies and/or workers pay premiums to private insurers that provide benefits for paid parental, family caregiving and/or personal medical leave (see Map 2). For example, Virginia enacted a law establishing paid family leave as a form of private insurance that employers can voluntarily purchase for their employees. While the law does not mandate coverage, it is expected to expand access to the benefit through public demand in a competitive labor market and by providing flexibility. NewHampshire and New York use private insurance models, but participation is mandatory.

States can opt to fully fund programs through mandated contributions. California, for example, fully funds their program through employee contributions, with no additional direct cost to employers. This means that the policy has functionally no impact on the state’s expenditures, though employees’ wages are impacted by paying into the program. 

Paid Parental Leave Duration, Eligibility & Protections
Duration, eligibility and job protections are among the areas where state paid parental leave policies differ. As it relates to duration, time ranges from a minimum of six weeks to a maximum of 12 weeks (see Map 3).

States may have a specific set of requirements that employees must meet in order to be eligible for paid family leave. These criteria may include the total number of hours or months worked, total wages earned, and size and type of the company. California, for example, requires employees to work at least 12 months for an employer, contributing 1,250 hours of service, prior to taking their paid leave. The District of Columbia requires employees to spend at least 50% of their time working in the district.   

Additionally, several states have also created policies to address job protections for employees who do take a leave of absence. Seven states — Colorado, Delaware, Maryland, Massachusetts, New York, Oregon and Rhode Island — have enacted policies that provide job protections for employees on leave.

Pay Amount During Leave 
The amount of pay that eligible employees receive while taking leave under the policies varies by state. In California, for instance, eligible employees can receive up to 60% to 70% of their weekly wages for a period up to six weeks, while New Jersey offers eligible employees up to 85% of their weekly wages for the same duration, while in New York, eligible employees can receive up to 50% of their weekly wages for up to 10 weeks. 

Impacts of Paid Parental Leave 
Research indicates that paid parental leave policies have positive effects on mothers, fathers and infants, resulting in increased leave-taking by both mothers and fathers. Several studies examining the effects of California’s paid family leave found that leave-taking doubled among mothers who extended leave by an average of three weeks, in addition to having a greater impact among economically disadvantaged mothers. 

Studies have also revealed benefits of paid parental leave on the health and development of children, as well as the mental health for mothers. For instance, it has been reported that paid leave reduces infant mortality and hospitalizations, which is not as common with unpaid leave. Paid leave also reduces stress and is beneficial for parents’ mental health. Mothers participating in paid leave have been shown to less commonly experience post-partum depression, and leaves longer than two to three months are expected to be especially protective. In addition to offering mothers improved mental health, longer leaves can lower stress and reduced hospitalization rates. Evidence on mental health benefits for fathers was more mixed and less conclusive.

Summary
The Federal Family and Medical Leave Act provides eligible employees up to 12 weeks of unpaid, job protected leave per year for the arrival of a new child, their own serious health condition or to care for a seriously ill family member. Despite this, no paid family leave policies exist at the federal level. The lack of federal law for paid leave allows states to develop their own policies to address this gap. They have accomplished this through funding structures, eligibility requirements, duration of time and pay during time off. Although states approaches may differ in providing paid family leave, research suggests that providing such opportunities presents benefits that unpaid leave does not. Benefits include positive impacts on child health and wellbeing, parental finances and parents’ mental health.

Associates in Action: Amazon Offers Scholarships, Mentorship for Future Engineers

By Katie Boggs

Amazon has awarded $16 million in scholarships to U.S. high school seniors across nearly 40 states to study computer science at the college of their choice beginning with the fall 2023 semester.

The 2023 Amazon Future Engineer Scholarship is a part of the company’s global philanthropic education initiative. The company allocates $40,000 for each recipient over the course of four years to pursue a degree in engineering or computer science. As well, the scholarship offers the opportunity of a paid internship position under the mentorship of Amazon leaders.

This year’s awardees comprise of seniors from nearly 40 states and territories, including Washington, D.C., and Puerto Rico. This cohort is said to be the most diverse yet, including many members of underrepresented groups in science, technology, engineering and math. More than 70% of the selected students identify as Black, Latino and Native American. Another 50% identify as a woman or nonbinary.

“With students from historically underrepresented and underserved communities representing only 18% of [computer science] bachelor’s degrees, we believe that connecting students to computer science education and opportunities helps create a more equitable and inclusive future, across all industries and sectors, for generations to come,” said Victor Reinoso, Amazon’s global director of philanthropic education initiatives.

The selection process includes academic achievement, demonstrated leadership, community involvement, work experience, future goals and financial need. In total, 400 students were granted this scholarship.

Micah Hill, a 2023 Amazon Future Engineer recipient from Laurel, Mississippi, shared that her brother’s academic achievements first inspired her to study computer science. Her sibling, Samuel, was a 2021 awardee of the Amazon scholarship. Based on her interests, Hill organized a week-long coding program for fifth- to eighth-grade girls to learn fundamentals in 3D printing in hopes to inspire young women in the field.

“I didn’t know the statistics regarding women in computer science were so disproportionate,” Hill said. “I wanted to provide girls in my community with an opportunity to learn how to code and print in 3D.”

With the support of her Amazon Future Engineer Scholarship, Hill will attend the University of Southern Mississippi and hopes to build a career at a large global tech company.

Angel Feliz, another 2023 Amazon Future Engineer recipient, moved from the Dominican Republic to Providence, Rhode Island, when he was just 9 years old. Feliz said he loves the diverse collaboration that his computer science work offers. He said that it counters the perception of a siloed environment that many have of the field.

“I’m a first-generation immigrant,” Feliz said. “This scholarship means that I will soon be a first-generation college student and can continue exploring pathways in technology without placing a financial burden on me and my family. It also helps me feel motivated. It is important to me to know that I have people supporting me along the way.”

Feliz plans to attend college in the northeast and major in computer science with a minor in cybersecurity.

Amazon is committed to reaching 2 million students from underrepresented communities across the U.S. with real-world, virtual, and hands-on computer science project learning. In addition to the U.S. program, Amazon Future Engineer, the company’s childhood-to-career computer science education program is available in Canada, France, Germany, India and the United Kingdom.

For more information, please visit https://www.amazonfutureengineer.com.

About Amazon Future Engineer
Amazon Future Engineer is a program designed to inspire, educate, and prepare children and young adults from underrepresented and underserved communities to pursue computer science. The program is part of Amazon’s $50 million investment in computer science and science, technology, engineering, and mathematics (STEM) education.

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

Associates in Action: Gilead Named Top Funder for HIV-Related Philanthropy

By Katie Boggs

Gilead Sciences, Inc., a CSG Associate, replaced The Bill & Melinda Gates Foundation as the top funder for HIV-related philanthropy, according to the Funders Concerned About AIDS (FCAA) 19th annual report.

The 2020 FCAA’s Philanthropic Support to Address HIV and AIDS Report was the first to examine the response of HIV-related philanthropy through the COVID-19 pandemic. Results showed that there is a shrinking pool of funders for this cause, as there was only a 1% increase in revenue compared to 2019, and 67% of the funding under this analysis was derived from the aforementioned top two funders.

Gilead’s donation in 2020 had an increase of $116 million compared to the previous year. On the other hand, 13 of the top 20 funders reportedly decreased donations in comparison to the 2019 report. Data showed that other private foundations also significantly reduced philanthropic spending on HIV or removed themselves entirely.

“The concentration of funding at the top is not a new headline, but it became starker in 2020,” said Channing Wickham, FCAA’s board chair and executive director of the Washington AIDS Partnership. “A shift in resources away from HIV, or other action with economic fallout from one of these top grantmakers could devastate future funding levels.”

Regardless of the statistics, Gilead continues to advocate and spread awareness of HIV and AIDS. In 2020, amidst the height of the pandemic, Gilead shared stories of its community partners that kept going during the difficult time on World AIDS Day. Aside from philanthropy, the company’s efforts are also evident in providing resources, programs and initiatives to support the cause globally.

“Gilead’s support for community organizations is part of our enduring commitment to ending the HIV epidemic,” said Daniel O’Day, Gilead Sciences chairman and chief executive officer. “We believe that real progress is only possible through collaboration and partnership. That is why we invest in the extraordinary efforts our partners are undertaking to reach underserved populations, eliminate barriers to care and educate communities. It is inspiring to see the work that goes on across these groups and we are proud to play a role in supporting them.”

For more information, please visit www.gilead.com.

About Gilead Sciences, Inc.
Gilead Sciences, Inc. is a biopharmaceutical company that has pursued and achieved breakthroughs in medicine for more than three decades, with the goal of creating a healthier world for all people. The company is committed to advancing innovative medicines to prevent and treat life-threatening diseases, including HIV, viral hepatitis and cancer. Gilead operates in more than 35 countries worldwide, with headquarters in Foster City, California.

About the Philanthropic Support to Address HIV and AIDS Report
The Philanthropic Support to Address HIV and AIDS Report first began its annual analysis of private funding to address HIV and AIDS in the year 2000. The current report captures data on more than 5,000 grants, awarded by 323 foundations in 10 countries, and identifies gaps, trends, and opportunities in HIV-related philanthropy. Sharing this study with funders enables them to make informed decisions about where their resources would make the most difference.

About FCAA
Funders Concerned About AIDS is a philanthropy-serving organization (PSO) founded in 1987 to take bold actions and push philanthropy to respond to HIV. FCAA informs, connects, and supports philanthropy to mobilize resources to end the global HIV pandemic and build the social, political and economic commitments necessary to attain health, human rights, and justice for all.

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

Protecting Disabled Veterans in the Workforce

By Joe Paul

As long as there has been war, veterans have been coming home. Many have injuries that make work difficult or make some careers impossible. Questions surround veterans who have sustained physical or mental injury in service of their country. Will I be able to work? How can I provide for my family? Will someone hire a veteran with injuries? Given the prevalence of these concerns, there is a federal support system in place to assist veterans.

The two laws integral to protecting veterans in the workplace are the Uniformed Services Employment and Reemployment Rights Act (USERRA) and the Americans with Disabilities Act. USERRA provides requirements for reemploying veterans both with and without service-related injuries, while Title I of the ADA outlines what qualifies as disabilities and accommodations. USERRA is enforced by the U.S. Department of Labor and the U.S. Department of Justice.

USERRA prohibits employers from discriminating against employees or applicants for employment based on their military status, including military obligations resulting from duties as part of the National Guard or Reserves. Reemployment protection for persons with or without service-related disabilities is also included.

All veterans are covered under USERRA regardless of disability status. The veteran is also protected by ADA if their disability falls under the ADA. Employers must make “reasonable efforts” to help a veteran returning to employment become qualified to perform the position they would have had if employment had not been interrupted by military service or if they sustained a disability during their military service.

Title I of the ADA, enforced by the Equal Employment Opportunity Commission and applying to all workers, prohibits private, state and local government employers with 15 or more employees from discriminating against individuals based on disability. Having a disability or having a history of disability cannot factor into any aspect of employment, such as hiring, promotions, assignments, training, termination, or any other terms, conditions or privileges of employment, including questions of access to training or social events that are employer sponsored.

If a veteran is diagnosed with PTSD, or if the employer believes that the veteran may have PTSD, it is illegal for the employer to refuse to hire the veteran if they are otherwise qualified for the job. The ADA also limits the types of medical information employers can obtain and strictly prohibits disability related harassment and retaliation. Section 501 applies those standards to the federal executive branch and U.S. Postal Service, among others.

If an employer can prove that employment of a person with disabilities would cause an undue hardship, employers can propose reasonable alternatives. Generally, undue hardships come at significant difficulty or expense to the employer. The ADA National Network defines “undue hardship” as an “action requiring significant difficulty or expense” given any number of circumstances. The size, resources, nature and structure of the employer’s operation must be considered. Many, if not all, of these provisions do not apply to employers of less than 15 employees. For example: if a chair lift is requested, an employer could propose a ramp as a reasonable alternative.

Many veterans self-eliminate themselves from viable career opportunities by thinking their injuries either disqualify them for a job or that performing the job would not be possible given their injuries. The reality is that veterans are protected if they meet the ADA’s definition, and the veteran is otherwise qualified for the job. An “individual with a disability“ is a person who (1) has a physical or mental impairment that substantially limits one or more major life activities; (2) has a record of such an impairment, such as a substantial limitation prior to undergoing rehabilitation; and (3) is regarded or treated by an employer as having such an impairment, even if no substantial limitation exists.

If the veteran is qualified for the job by meeting the employer’s requirements for education, training, experience, skills, licensure or other requirements, and would be successful in the position with or without accommodations, they must be considered. There are additional requirements if the employer is the recipient of federal funds.

Disabled veterans should be aware of the 2008 ADA Amendments Act which added the term “major life activities,” and defined them to include not only activities such as walking, seeing, hearing and concentrating, but also the operation of major functions of the brain and neurological system. A list of reasonable accommodations for veterans with any of these disabilities can be found on the U.S. Equal Employment Opportunity Commission’s website.

An impairment should not prevent or severely or significantly restrict a veteran’s performance of a major life activity to be considered substantially limiting. The determination of whether an impairment substantially limits a major life activity must be made without regard to any mitigating measures, including medications or assistive devices such as prosthetic limbs, that you may use to lessen your impairment’s effects. Impairments that are episodic or in remission, such as epilepsy or PTSD, are considered disabilities if they would be substantially limiting when active.