The visit included a hosted lunch for alumni and eligible members of this year’s WLA, as well as a morning with coffee and donuts aimed at connecting with legislators and legislative staff.
Throughout our visit, many positive comments and remembrances from last year’s 75th CSG West Annual Meeting that convened in Boise were shared and reconnecting with all of the people who worked so hard to make that meeting a success. The CSG West staff were grateful and appreciative of the warm welcome and hospitality extended during our visit to the Gem State.
Idaho Representative Ned Burns, House Minority Caucus Chair, with Jackie Tinetti, CSG West Policy Analyst
The Council of State Governments works to help state officials solve problems and share information with other policymakers across the U.S. As a nonpartisan association of all state officials, elected and appointed, the work of CSG is research informed in order to help states identify solutions that help their communities. We recognize that no single solution works for everyone, but we can learn from the successes — and failures — of other states.
Through extensive survey work conducted by the CSG Center of Innovation research team, the CSG national office identified five top priority public policy issues that — in addition to work in other areas — CSG policy staff will expand on and provide resources for during 2023:
INFRASTRUCTURE AND TRANSPORTATION.
FISCAL AND ECONOMIC POLICY.
HOUSING.
MENTAL HEALTH INCLUDING SUBSTANCE USE DISORDER.
EDUCATION AND WORKFORCE.
Each issue of CSG Capitol Ideas magazine in 2023 will focus on the work states are doing in each of these policy areas. This issue kicks off with a deeper dive into mental health and the different ways states are working to address this growing issue.
STATE ACTIONS TO ADDRESS MENTAL HEALTH Nine out of 10 adults in the U.S. believe the country is experiencing a mental health crisis. With that consideration, which resulted from a poll conducted by CNN and the Kaiser Family Foundation, and the topic of mental health gaining more attention in the conversations surrounding health care and wellness, many states are directing efforts at some of the most pressing concerns.
Recently, these have included suicide prevention (a leading cause of death in the U.S.), children’s mental health (1 in 6 children between the ages of 2 and 8 has a diagnosed mental, behavioral or developmental disorder), and expanding access to care. Mental Health America’s 2022 report provided a state-by-state look at access to mental health services, ranking states overall and in a number of categories including adult mental health, youth mental health, prevalence of mental illness and access to care.
SUICIDE PREVENTION In 2020, there were 45,979 deaths attributed to suicide, or one death every 11 minutes. Even more people thought about or attempted suicide with more than 16 million adults seriously thinking about, planning or attempting suicide.
Suicide is now ranked as the 12th leading cause of death in the U.S. overall and is the second leading cause of death for children between the ages of 15 and 19 years old. As cases of mental health conditions rise and the search for solutions continues, specialists around the nation are calling it a national mental health crisis.
A number of states passed legislation to fund and implement the new National Suicide Prevention Lifeline, 988, in 2021. Experts hope that the inclusion of 988, dubbed by some as the mental health equivalent of 911, will successfully prevent more people from dying due to mental health concerns. Colorado (Senate Bill 21-154; 2021) and Washington (House Bill 1477; 2021) established telecommunications charges and appropriated funds to support the help line’s implementation and working groups to provide recommendations and/or oversee and administer the hotline.
Individuals who identify as LGBTQ+ experience disproportionate levels of poor mental health and suicidality. According to a survey conducted in 2021 by the Centers for Disease Control and Prevention looking at high school students, 25% of lesbian, gay or bisexual students attempted suicide during the past year compared to 5% of heterosexual students. States have passed legislation to support this population, both by protecting them from practices that have been linked to substantialharm as well as by enacting bills that increase access to LGBTQ+ affirmative care.
In 2021, North Dakota enacted new ethics standards in alignment with the American Psychiatric Association’s Guidelines for Psychological Practice with Sexual Minority Persons and the APA’s Position Statement on Conversion Therapy and LGBTQ Patients that prohibit licensed social workers from subjecting LGBTQ+ youth to conversion therapy and require practitioners to use therapies that affirm individuals’ sexual orientations and gender identities. During the 2021 and 2022 legislative sessions, Illinois (SB 4028) and Vermont (HB 210) enacted bills creating task forces that will provide recommendations for increasing access to LGBTQ+ supportive care.
CHILDHOOD MENTAL HEALTH In recognition of the role of schools as a crucial access point to youth mental health care, states have enacted at least 100 laws since early 2020 aimed at supporting schools in the delivery of school-based mental health services. Some examples of this recent legislation include:
Connecticut: HB 6621 (Public Act No. 21-95, enacted June 2021) established requirements for the School Emotional Learning and School Climate Advisory Collaborative, which will develop a strategy to initiate collaborations with community-based mental health providers and support school staff in mental health and social-emotional learning. Connecticut SB 2 (Public Act No. 21-46, also enacted in June 2021) requires local boards of education to allow students to take up to four mental health days per school year.
Illinois: SB 818 (Public Act 102-0522, enacted August 2021) requires that health education courses for students include information on mental health.
Massachusetts: H 4002 (Chapter 24, enacted July 2021) appropriated funding for a pilot program for telebehavioral health services through schools.
North Carolina: SB 105 (SL 2021-180, enacted November 2021) allocated funding from the American Rescue Plan Act to establish a grant program for schools to hire psychologists in response to COVID-19.
Rhode Island: SB 31/HB 5353 (Chapter 131, enacted April 2021) requires that school staff and students receive education on suicide awareness and prevention.
Texas: SB 279 (enacted June 2021) requires schools to include crisis line contact information on all identification cards for students in grades six through twelve.
Virginia: SB 1288/HB 2299 (Chapter 452, enacted March 2021) requires that school counselors receive mental health training in order to obtain and renew their license.
Attitudes and stigma around mental health were one of the topics addressed in a 2021 study on mental health at work published by the organization Mind Share Partners. According to the study, the country may be witnessing a subtle shift in those attitudes in the wake of the impacts of COVID-19.
58% of respondents were willing to hire or work with someone with a mental health condition, up from 46% in 2019.
55% of respondents believe that an employee with a mental health condition could be just as productive as one without, up from 52% in 2019.
55% said they knew someone personally with a mental health condition, up from 50% in 2019.
READ MOREabout states addressing stigma and employability on the State Talk blog.
ACCESS TO CARE Many states have expanded behavioral health care in Medicaid to address mental health and substance use outcomes. Many of these initiatives extend beyond Medicaid enrollees and funding. Researchindicates that Medicaid expansion, and the resulting increase in mental health coverage, is associated with a decrease in suicide mortality.
Montana’s Healing and Ending Addiction through Recovery and Treatment 1115 demonstration waiver expands access to treatment and recovery services, improves transitions of care across treatment levels, and seeks Medicaid coverage for evidence-based substance use disorder treatment models and pre-release care management for individuals involved in the justice system. In another state example, North Dakota’s Medicaid 1915(i) state plan amendment, authorized by SB 2012, allows North Dakota Medicaid to pay for 12 additional home and community based services to support individuals with behavioral health conditions. The program includes policies that address rural challenges.
MENTAL HEALTH PARITY Disparities in mental health coverage persist despite Congress passing the Mental Health Parity and Addiction Equity Act in 2008. The bill, requiring equitable coverage of mental health and substance use disorder treatment, was further bolstered by the 2010 AffordableCare Act’s requirement that most health plans cover mental health and substance use disorder care. Some forms of insurance, such as Medicare, the Veterans Administration and short-term limited duration health plans, are able to place limitations on mental health coverage and the laws don’t require parity in reimbursement rates, making it difficult or impossible to find in-network mental health care providers.
Although states must meet the minimum standards established by the MHPAEA, some have taken steps to make their laws more rigorous, to have a broader scope, or to oversee enforcement. During the 2021 and 2022 legislative sessions, at least 14 states passed parity laws: Maryland, Wyoming, Oklahoma, Montana, Oregon, Ohio, Kentucky, Missouri, Colorado, Florida, Georgia, Illinois, Nevada and Washington.
In 2021, both Ohio SB 284 and Missouri HB 604 enacted legislation requiring their state insurance directors to issue regulations and enforce the MHPAEA. And Illinois SB 0471 expanded and clarified requirements for insurers to provide timely access to treatment.
Some state’s bills expand telehealth options while others focus on oversight and reporting requirements. In Maryland, SB 3 amended the state’s telehealth law to promote coverage for mental health and substance use disorder services. Additionally, Nevada AB 181 requires providers and insurers to report suicide attempts to the chief medical officer for parity compliance.
ADDITIONAL RESOURCES 50-State Medicaid Budget Survey for Fiscal Years 2021 and 2022, Kaiser Family Foundation (VIEW)
National Alliance on Mental Illness State Legislation Report: Trends in State Mental Health Policy (2019), National Alliance on Mental Illness (VIEW)
Mental Health America State Policy Recommendations: Youth Mental Health, Mental Health America (VIEW)
Learn how The Council of State Governments works for you
Welcome to The Council of State Governments and our very best wishes to you as you take on this important role in publics service. Here at CSG, we know the monumental tasks that you’ll face and how important the impact of your work will be. Don’t worry, we’re here to help. At CSG, we work for you; our priorities are determined by state officials, and we hope you come to think of CSG as part of your team.
CSG is America’s largest organization of state officials and the nation’s only nonpartisan, nonprofit 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.
CSG NATIONAL
The CSG national office, located in Lexington, Kentucky, houses research, public policy, publications and special initiatives through partnerships with the federal government and other community and research organizations that foster collaboration and community between elected and appointed officials from across the country and the six U.S. territories. At the CSG national headquarters, staff work within the Center of Innovation, home to all public policy analysis, research and grant projects, and the National Center for Interstate Compacts as well as on national initiatives including CSG Capitol Ideas magazine, the CSG Henry Toll Fellowship and the CSG 20 Under 40 Leadership Award. Learn more at csg.org.
CSG REGIONS
CSG East | CSG Midwest | CSG South | CSG West Regional by design, these offices across the U.S. allow state officials to connect on shared issues that are geographically based, including federal lands, water rights, agriculture, border relations and more. CSG regional offices also host conferences, in-state visits and leadership development programs that allow officials to network regionally. The regional offices incorporate the CSG Eastern Regional Conference, CSG Midwestern Legislative Conference, the CSG Southern Legislative Conference, and CSG West.
CSG JUSTICE CENTER
The CSG Justice Center brings together state and local officials along with subject matter experts to discuss challenges and best practices in policy areas directly related to issues of public safety and justice. Learn more at csgjusticecenter.org.
Look Ahead to What CSG Has Planned for 2023!
CSG NATIONAL CONFERENCE Dec. 6-9 | Raleigh, North Carolina Each year, CSG hosts its national conference to bring together hundreds of state leaders from across the U.S., the U.S. territories and Canada. The CSG National Conference spotlights national public policy priorities through interactive sessions designed to engage officials from all three branches of government.
HENRY TOLL FELLOWSHIP Aug. 16-20 | Lexington, Kentucky Named for CSG Founder Henry Wolcott Toll, this fellowship is the nation’s premier leadership development program for state government officials. The Toll Fellowship brings together 48 of the nation’s top state government officials from all three branches of government for an intensive week-long course. Application deadline is May 1. Apply or nominate here: CSGOVTS.INFO/TOLLS.
NEW LEGISLATIVE LEADERS ACADEMY June 14-16 | Chicago Recognizing its strength in establishing peer networks among leaders, CSG will provide a new professional and leadership development experience for legislative leaders. The New Legislative Leaders Academy educates participants on the legislative institution, separation of powers, ethics and civility.
MEDICAID POLICY ACADEMY Sept. 18-22 | Washington, D.C. In 2023, the Medicaid Policy Academy will combine the Medicaid 101 Policy Academy and the Medicaid Leadership Academy into a two-part, five-day program to provide leadership development through policy analysis for state legislators. In two separate classes, this program will bring together 30 state administration and legislative officials who are engaged with health care policy for a dive into the policy and conversations surrounding governing Medicaid programs.
CSG 20 UNDER 40 LEADERSHIP AWARD This annual honor recognizes the work of 20 up-and-coming elected and appointed officials from across the country who demonstrate the ability to work across the aisle in meaningful ways relevant to the CSG mission of helping states advance the common good. Apply or nominate a leader by Aug. 1 here: WEB.CSG.ORG/20-40.
REGIONAL ANNUAL MEETINGS The CSG regional annual meetings are signature events convened each summer by the CSG regional offices. Each event is unique to its region and brings together state policymakers of all levels and branches, from those just finishing their freshman sessions to Senate presidents and speakers of the House. Each meeting includes programming that features strong host state pride, enriching public policy discussions and leadership development trainings.
Want to learn more about how CSG works for you and discover ways to get involved in this nonpartisan organization of state officials? Visit csg.org/new-members.
DID YOU KNOW The CSG National Headquarters office is located in Lexington, Kentucky. CSG has regional offices in New York City, Atlanta, Chicago and Sacramento, California. It also has an office in Washington, D.C., and the CSG Justice Center in New York City.
The Council of State Governments began in October 1933 when a small group of state legislators gathered in a room at the Penn Harris Hotel in Harrisburg, Pennsylvania. CSG founder Colorado state Sen. Henry Toll was meeting with the Board of managers of the American Legislators Association, a group he founded in 1925. One of Toll’s first items of business was to compile a list of all 7,500 state legislators in the country, a roll that did not exist until he put one together.
Regional Leadership Programs
BOWHAY INSTITUTE FOR LEGISLATIVE LEADERSHIP DEVELOPMENT (BILLD) Aug. 18-22 | Madison, Wisconsin BILLD is a five-day leadership training program designed for lawmakers of the Midwestern Legislative Conference’s 11 member states. The program offers newer legislators an opportunity to improve their leadership skills, explore ongoing issues, and connect with nationally renowned scholars, professional development experts, and legislative leaders and colleagues from across the region. CLICK TO LEARN MORE.
EASTERN LEADERSHIP ACADEMY (ELA) Aug. 27-31 | Philadelphia Each year, 30 state and provincial officials from the 18 CSG Eastern Region member jurisdictions gather in Philadelphia for the Robert J. Thompson ELA. This select group of state officials from all three branches of government receives training to enhance their leadership and communication skills from a variety of experts in media, education and government. CLICK TO LEARN MORE.
CENTER FOR THE ADVANCEMENT OF LEADERSHIP SKILLS (CALS) Oct. 15-19 | Nashville, Tennessee CALS is a five-day workshop bringing together 30 elected or appointed officials from Southern Legislative Conference member states in a strictly nonpartisan environment. Selected CALS scholars participate in activities and instruction focusing on the program’s four central components: communication, conflict resolution, consensus building and critical decision making. CLICK TO LEARN MORE.
STAFF ACADEMY FOR GOVERNMENTAL EXCELLENCE (SAGE) Nov. 12-16 | Atlanta SAGE is a professional leadership development program for Southern state legislative, judicial, executive and agency staff. In addition to developing their personal and professional leadership skills, participants can build a network of peers from across the Southern region.
WESTERN LEGISLATIVE ACADEMY (WLA) Dec. 12-15 | Colorado Springs, Colorado Western region state legislators are selected to participate in the multi-day WLA training experience focused on sharpening leadership skills needed to excel in a legislative environment. Faculty from academic, military and legislative backgrounds engage class members in interactive sessions designed to provide a learning experience that expands understanding and fosters relationships. CLICK TO LEARN MORE.
Advocates, skeptics of rapidly advancing technology eye regulations, revisions
This image, “Renaissance Painting of Politics,” was created with the assistance of DALL-E.
By Dr. Dakota Thomas and Caroline Wills
Computing changed the world. Twenty years ago, many jobs did not require use of computers. Now, most require them for key functions — or to even exist. On its own, computing is changing rapidly. The advent of machine learning and artificial intelligence may change humanity’s relationship with technology forever, and is expected to have important consequences for the economy and society of the near future.
Until recently, computing relied on providing computers with instructions. In traditional programming, a human writes a program and the computer executes it exactly as instructed. A form of computer programming, machine learning is a specific approach to achieving AI. It moves beyond human direction; computers are now taught to create their own instructions using specific protocols. Currently, little government oversight exists for this emerging technology.
THE DAWN OF AI AND MACHINE LEARNING As part of machine learning, a computer learns what to do without explicit instruction from a human. Artificial intelligence, or AI, is the simulation of human intelligence in machines, teaching a computer to think, learn and perform tasks like a human. AI is the broader concept of teaching machines to perform tasks that would normally require human intelligence, while machine learning uses data and certain techniques to train computers to do such tasks. Using a learning algorithm, computers create a model from training data in order to make predictions or decisions that were not explicitly programmed. A learning algorithm can achieve more in less time compared to human programming alone through the automation of complex, time-consuming tasks.
An algorithm is a sequence of instructions or operations used to solve a problem or perform a calculation, while training data is any form of data that can be used to teach a learning algorithm what to do.
As a result, machine learning drastically increases productivity and requires less human thought and labor. Consider, for example, spam filters for emails. Although a human programmer could feasibly update programming to block spam, spammers can quickly adapt and bypass filters. By contrast, a computer program is continually trained with data generated by users flagging spam messages and can easily create a comprehensive filter and automatically update its approach as threats become more complex.
Machine learning and AI are advancing so rapidly that language and art AI can mimic human conversation and human generated art. ChatGPT, a language model AI chatbot, was designed by OpenAI to perform writing tasks like a human would as well as to respond to questions and commands. When it debuted last year, people were spooked by how much it can do and how well it mimics human writing. In fact, the chatbot has passed graduate level writing exams in multiple fields including the U.S. medical licensing exam and several law classes.
Writing a program similar to the one allowing ChatGPT to respond is extremely complicated and time-intensive for a human programmer. But since ChatGPT has been taught how to respond to requests, it responded in seconds and can answer many other kinds of requests as well.
Q&A with ChatGPT
“Can you provide an example of AI for a website?”
ChatGPT’s Response: There are many ways that artificial intelligence can be used on a website to improve the user experience and make it more interactive and engaging. Here are a few examples of how AI can be used on a website:
Chatbots – Chatbots are computer programs that use natural language processing to simulate a conversation with a human. They can be used on a website to provide customer support, answer frequently asked questions, or guide users through the purchasing process.
Personalization – AI can be used to personalize the content and recommendations shown to a user on a website based on their past interactions and behaviors. This can help to create a more personalized and relevant experience for the user.
Image Recognition – AI can be used to analyze and classify images on a website, for example to tag photos with relevant keywords or to provide alternative text for visually impaired users.
These are just a few examples of how AI can be used on a website. There are many other potential applications of AI in this context, and the use of AI in web development is an active area of research and development.
AI STRIKES BACK: NEW PROBLEMS FROM NEW TECHNOLOGY As with any new technology, the advancement of AI and machine learning tools has its shortcomings. Among them is AIgiarism, plagiarism enabled by AI programs, along with biased algorithms due to flawed training data, potential job displacement as result of automation, and cultural impacts on how creativity and art are viewed.
The concept of machine learning can be misleading. ChatGPT and other AI do not actually know anything in the ordinary sense of the word — yet. Instead, these tools have had a vast amount of information fed to it by humans. For ChatGPT, that data comes from online text that is repackaged and redistributed.
Since the authors of that online text probably did not agree to having their text used to train ChatGPT, and the chatbot does not cite its sources, it’s difficult to know how ChatGPT learns all the information it generates. It also leads to questions about the information’s accuracy and whether the chatbot is plagiarizing others. According to Slate, there are published examples of chatbots copying other journalists’ work for use in another publication’s article.
Setting aside the ethics of training data, AIgiarism has already created concerns in the educational system, where teachers and professors recognize that students can use AI, like ChatGPT, to do their homework. There is a plagiarism checker in development specifically designed to try to determine if ChatGPT wrote a paper rather than a student. Educational institutions nationwide are creating academic task forces and regulations to address the emerging issues of AIgiarism. To their credit, AI developers addressed the issue with a new tool.
Scott Aaronson, a researcher at OpenAI, revealed on his blog that his primary project had been “statistically watermarking the outputs of a text model like GPT,” making it harder for their ChatGPT algorithm to pass off information as if it came from a human.
“Whenever GPT generates some long text, we want there to be an otherwise unnoticeable secret signal in its choices of words, which you can use to prove later that, yes, this came from GPT,” Sorenson said. “This could be helpful for preventing academic plagiarism, obviously, but also, for example, mass generation of propaganda.”
The problem of plagiarism is not unique to language AI, as similar issues with AI generated art have also begun causing controversy. Last year, the winner of the Colorado State Fair’s annual art competition used AI tocreate their winning image, sparking a heated discussion on the impact of AI on human creativity, copyright and artistic expression. As with language AI, human generated art is used to train art AI, and typically the creators of that art are not asked permission or compensated for their work. Although AI is already drastically changing creative processes and artistic expression by convincingly mimicking human generated art, it may be difficult for AI to replace human imagination and innovation in the future. AI can effectively mimic human creativity and expression, but it is unclear if it can replace artists altogether.
ROBOTS ON THE JOB Other professions may be even more vulnerable to displacement by AI automation. This could contribute to higher unemployment and other social and economic consequences. According to the 2020 World EconomicForum Future Jobs Report, AI could displace up to 85 million jobs globally — many of which are expected to be blue-collar positions. The report also revealed as many as 97 million jobs could be created; however, the jobs created will likely be white-collar roles such as programmers. By 2025, the report speculates that employers will equally divide work between human and machines; roles requiring human skills will rise in demand; information and data processing will be the primary task of machines; and administrative tasks and routine manual jobs will be the primary responsibilities of white- and blue-collar workers.
Since AI relies on human generated data, it can exhibit the same biases as humans. Commonly called algorithmic bias, it has been increasingly creeping into areas of human life. Beginning in 2014, Amazon tried utilizing AI to build a resume-screening tool to make hiring more efficient. The algorithm was trained using resumes collected by Amazon. Many of those resumes were from men, and due to the biased input, the system learned to discriminate against women applicants.
REGULATING THE FUTURE OF AI The field of AI is advancing so quickly that some researchers estimate an AI with superhuman intelligence will be created this century. Despite the rapid pace of technological advancement and innovation surrounding machine learning and AI, few policymakers are well versed on the subject. One notable exception is U.S. Rep. Don Beyer, who, at age 72, enrolled in an AI undergraduate program at George Mason University.
California Rep. Ted Lieu introduced a congressional resolution written by AI in January, directing the U.S. House of Representatives to delve into the challenges of artificial intelligence and the need for increased regulation. Consequently, Lieu is the first member of Congress to introduce AI authored material. In an op-ed published by The New York Timesahead of the release of his resolution, Lieu wrote: “We can harness and regulate A.I. to create a more utopian society or risk having an unchecked, unregulated A.I. push us toward a more dystopian future.”
At a state level, Massachusetts Sen. Barry Finegold used ChatGPT to draftdata privacy legislation. Finegold and his office gave ChatGPT broad prompts, leading it to create a nearly complete document. Finegold filed the bill to show the benefits of AI, while also highlighting the need for guardrails to protect public safety.
While billions are spent every year advancing AI capability, only $50 million was spent in 2020 on reducing its potential risks. Added oversight and regulation could ensure that AI assists humans moving forward in creating a sustainable and inclusive future that avoids the potential risks of AI proliferation. By investing in applied AI research, promoting transparency and accountability in AI, developing comprehensive ethical guidelines, and proposing regulations and restrictions on AI, policymakers can work to smooth the transition to a world with more AI in it.
Machine Learning Techniques
Beyond the general styles of machine learning, there are also specific techniques used. These techniques include neural networks, decision trees and regression.
NEURAL NETWORKS Neural networks seek to replicate the human brains neural connections. Using models, artificial neurons are created that communicate with one another via a signal. Under certain conditions, signals become stronger or weaker, and the overall network learns to manage new information. For example, you can feed an artificial neural network images labeled “cat” and “not cat.” The network will try to learn how to classify images as cats. The network can then try to identify cats in new images it hasn’t seen before.
DECISION TREES Decision trees are another technique for supervised learning. Using several input variables, a decision tree attempts to classify relevant features to predict an outcome. This approach is one of the simpler types of machine learning with decisions that are more easily understood.
REGRESSION A more recently identified form of supervised learning is regression, which is the use of statistical modelling to estimate relationships between one or more output variables and a set of input variables. Regression can be used to make predictions and forecasts, as well for inference of relationships between variables. For instance, if the economy improves by X%, inflation will likely change by Y%.
Genetic algorithms use a simulated evolutionary cycle to solve problems. It does this by first creating a population of potential solutions before checking to see how well each solution works and assigning a score. Solutions are then reproduced and combined and/or changed to create even better solutions. This process repeats a select number of times until a sufficiently good solution is reached. Genetic algorithms can be considered supervised or unsupervised learning, depending on the specific application.
Styles of Machine Learning
The field of machine learning is a new one, and scholars debate how best to think about it. Generally speaking, there are three styles of machine learning: supervised, unsupervised and reinforcement.
SUPERVISED During supervised learning, a computer is given example inputs and desired outputs. The computer’s goal is to learn rules that map specific inputs to specific outputs. For example, an individual might use a data set of labelled handwritten characters to train a computerhow to read handwriting correctly.
UNSUPERVISED Unsupervised learning occurs when no labels are given to the inputs, so the computer must find structure in the inputs on its own. This is sometimes referred to as data mining, which is looking for previously unknown patterns in data. An example of this may take place when an online retailer uses unsupervised learning to predict future purchases and make relevant recommendations based on a customer’s past behavior.
REINFORCEMENT The third machine learning style, reinforcement learning, involves computer interaction with a dynamic environment while attempting to accomplish certain tasks. Throughout this process, the computer is given feedback as if it is reward. It then continues trying to maximize the reward it receives. This style takes place in self-driving cars programmed to avoid obstacles. The car is rewarded for successfully navigating without errors, thus improving its approach to navigation.
The 2023 CSG National Officers pursue their passion for public service by leading The Council of State Governments
By Cody Porter and Trey Delida
Gov. John Carney Delaware | 2023 CSG National President
The Council of State Governments ushered in its 90th anniversary with the election of Delaware Gov. John Carney as 2023 CSG National President at its national conference in December.
Carney, who succeeds Hawaii Gov. David Ige as national president, became Delaware’s 74th governor in January 2017 and began his second term in January 2021. From 2011 to 2017, Carney served as a member of the U.S. House of Representatives. His six years of service in the House followed two terms as Delaware lieutenant governor, taking place during Gov. Ruth Ann Minner’s administration, from 2001 to 2009.
“I am honored to serve as the national president of The Council of State Governments in 2023,” Carney said. “I look forward to working with state leaders across the country to advance issues that are important to all of us — making sure we have safe communities, a strong and growing economy, and world-class public schools for all our children.”
In becoming CSG National President, Carney joins his predecessors from The First State, Govs. Minner and Jack Markell, both of whom previously served in the role. Minner, the first female national president, served her one-year term in 2005. Markell, who succeeded Minner in 2009 as Delaware governor, was national president in 2016.
Delaware Gov. John Carney joined students of Rehoboth Elementary School to plant trees in observance of National Arbor Day on May 6, 2022.
“Governors Minner and Markell had a way of giving everyone a seat at the table. We call it The Delaware Way,” Carney said. “It means that we work together, get to know our colleagues from both parties, and put partisan differences aside to get things done for our communities. That’s what Delawareans expect from us, and I believe that’s what makes us such effective leaders. That philosophy is exactly what CSG is all about.”
Carney’s belief in practicing The Delaware Way has paid dividends for his state. He embarked on his first term as governor intent on developing a competitive economy, improving educational opportunities and implementing a sustainable financial plan. Even when tasked with navigating COVID-19, he managed to address the needs of the state with assistance from Delaware communities and the Legislature.
As a Delaware congressman, Carney supported the return of American manufacturing jobs through the Make It In America agenda. He also promoted job growth for small- and medium-sized businesses as lead sponsor of the Jumpstart Our Business Startups, and again as lead sponsor on a bill assisting veterans in their transition to the job market.
“During his tenure as a public servant at the local, state and federal level, Governor Carney has distinguished himself as a problem solver and an innovator,” said David Adkins, CSG executive director/CEO. “He has consistently demonstrated the ability to bring people together and, as a result, he has produced impressive results for the people he serves.”
Although COVID-19 tested Carney and fellow state leaders, other more unique challenges await in the year ahead. Among them is an economic imbalance that consists of a large discrepancy between available jobs and the workforce.
“Across the country, and certainly in Delaware, we now have more jobs available than people looking for work,” Carney said. “That’s something I’ve never seen before in my career in public service, and a big part of that challenge is the large number of vacancies within state government.”
In its position as a nonpartisan representative of the states, Carney said the platform of CSG allows states to benefit from shared “best practices and lessons learned.” Such opportunity can produce “outside the box” thinking that states can adopt to combat economic struggles by generating jobs competitive with the private sector.
“CSG is all about partnership and working together. State governments across the country are facing the same challenges, regardless of who is in the majority,” Carney said. “Throughout my term as national president, I will be committed to bringing members together to discuss these issues. I hope CSG will be a platform for all of us to find common ground and work together on real solutions that will benefit our communities.”
Fast Facts
Years in Public Office: 22
Positions: Lieutenant Governor (2001-09), State Representative (2011-17), Governor (2017-Present)
Education: Dartmouth College (B.A., 1978), University of Delaware (M.P.A., 1987)
Interesting Tidbit: The son of educators, Carney attended Dartmouth College to pursue his degree and further his football career. On the gridiron, he was named All-Ivy League and Most Valuable Player. Upon graduating from Dartmouth, Carney accepted a position to coach freshmen football at the University of Delaware where he also earned a master’s degree in public administration.
Rep. Julia Howard North Carolina | 2023 CSG National Chair
Rep. Julia Howard is one of the longest serving members of the North Carolina Legislature. First elected to the state’s District 79 in 1989, she represented her constituents there for more than 30 years. In 2019, Howard was elected to represent District 77, where she currently serves Rowan County, Yadkin County and her home, Davie County.
Throughout Howard’s decades of service, she sat on and chaired several House committees, including banking, energy and public utilities, and finance. Passionate about policies that impact North Carolina families, she has dedicated her career to issues like welfare reform, aiding small businesses and child protection laws.
One of Howard’s most notorious feats comes from her leadership through the Great Recession of 2008. North Carolina had amassed a debt to the federal government totaling $2.7 billion on top of exhausting its unemployment trust fund. Howard’s legislation restructured the state’s unemployment system to avoid significant federal unemployment tax increases on small businesses.
An active member of CSG throughout her career, Howard was named national vice chair of the organization in 2020, a position she served in for two years before advancing to her role as chair-elect as a result of the COVID-19 pandemic. A 2008 CSG Henry Toll Fellow, she also served as chair of the CSG Southern Legislative Conference in 2007-08.
During Howard’s steadfast leadership, CSG has grown as an organization, and she looks forward to working to connect state leaders to address today’s pressing policy issues.
Fast Facts
Years in Public Office: 34
Positions: State Representative (1989-Present)
Education: Salem College (B.A., 2003)
Interesting Tidbit: Outside of the Legislature, Howard is a licensed real estate broker and appraiser who owns and operates Howard Realty in Davie County. Howard enjoys gardening in her spare time.
Rep. Kevin Ryan Connecticut | 2023 CSG National Chair-Elect
Rep. Kevin Ryan, a deputy speaker and 15-term veteran of the Connecticut General Assembly, serves the towns of Bozrah, Montville and Norwich in the 139th House District. His career in public service spans 30 years, all of which has been as a member of the Public Health Committee and the Appropriations Committee. During eight of those years, Ryan was House chairman of the Labor and Public Employees Committee.
In 2023, Ryan embarked on a new role as CSG National Chair-Elect. Through this role with CSG, he served on the Strategic Planning Committee, learning the scope of services and opportunities offered by the organization. Ryan hopes to use his new CSG platform to foster continued growth of the organization and its members.
“I hope that CSG can continue to grow as a resource for legislators, legislative staff, and members and staff of the judicial and executive branches through webinars, regional and national conferences, and research on specific topics,” Ryan said.
Ryan attended the Robert J. Thompson Eastern Leadership Academy and is a CSG Henry Toll Fellow. He serves on the National Conference of State Legislatures Task Force on Agriculture and on the NCSL Executive Committee representing CSG East.
In addition to his career in public service, Ryan gives back to his community through his involvement with Big Brothers Big Sisters of Southeastern Connecticut, where he serves as president. He previously worked as a clinician and optometrist, as well as vice president of Uncas Foods Inc., a family-owned business.
Fast Facts
Years in Public Office: 31
Positions: State Representative (1993-Present)
Education: Villanova University (B.A., 1974; B.S., 1976), Pennsylvania College of Optometry (O.D., 1978), University of New Haven (M.A., 1989)
Interesting Tidbit: A dedicated educator, Ryan served on the Montville Board of Education for seven years before his election to the Connecticut House of Representatives. He has been an adjunct physics professor at the University of New Haven since 1980.
Sen. Elgie Sims Illinois | 2023 CSG National Vice Chair
The legislative pathway of Sen. Elgie Sims was cemented just over a decade ago, built upon a foundation that is his devout devotion to Illinois communities. As senator for the 17th District, such support actively impacts Chicago’s south side, south suburbs, and Will and Kankakee counties.
Sims’ increasing involvement as a legislator at the local and state levels has since grown to include the national landscape. The four-year member of the CSG Midwestern Legislative Conference was nominated by his MLC peers to join the CSG Executive Committee, resulting in his selection as 2023 CSG National Vice Chair.
“I’m a former baseball player so I know the importance of a utility player,” Sims said. “My role and goal this year is to support the vision and leadership of CSG National Chair Julia Howard and CSG President John Carney. I want to make sure that I’m doing just that so that we can continue creating this forum for discussions of excellence in state government. It’s so important that we have that forum and the ability to forward policy at the state level.”
Sims, who is chair of the Senate Appropriations Committee, also served as MLC Chair in 2019. In 2014, he graduated from his first of two prominent leadership programs associated with CSG: The Bowhay Institute for Legislative Leadership Development of the MLC. Sims then graduated from the CSG Henry Toll Fellowship in 2015.
“Through my leadership experiences, I’ve had the opportunity to develop more personal relationships,” Sims said. “There were people in my BILLD and Toll classes who I knew for years before either of us ever figured out the party affiliation of the other. I think that’s a testament to the relationships you establish, and that’s really the benefit of being involved with CSG. It’s a nonpartisan organization that focuses on excellence in state government.”
Sims’ foray into public service began in 2012 upon getting elected to his first of nearly four terms representing the 34th Illinois House District. His contributions during that time have most notably reduced disparities in school funding, generated growth among small businesses, stimulated employment among the middle class and youth, and strengthened community and law enforcement relationships.
Through his affiliation with CSG, Sims said he and his legislative counterparts benefit from the nonpartisan forum made available by the organization. It’s in such settings that conversation and thought sharing result in support and proactive response, like that of Sims’ economic work, leading to an improved quality of life for state residents.
“There’s certain conversations that you cannot have on the Senate or House floors because they may become political and partisan,” Sims said. “If we are able to come together — not as Democrats or Republicans, or moderates or progressives — we have a forum to talk about the issues concerning our constituents.
“I think CSG is uniquely positioned as a nonpartisan organization focused on excellence in state government to create opportunities for discussion that can occur in an authentic way to help forward policies that create pathways to understanding.”
Fast Facts
Years in Public Office: 11
Positions: State Representative (2012-18), State Senator (2018-Present)
Education: Illinois State University (B.A., 1993), University of Illinois (M.P.A., 1997), Loyola University Chicago School of Law (J.D., 2007)
Interesting Tidbit: Sims maintains his involvement as a community leader and is a member of many civic organizations. As part of these endeavors, he provided books and scholarships to countless children in need.
2023 CSG Regional Officers
CSG EAST
Ted Arnott, Speaker of the Legislative Assembly of Ontario | Co-Chair First elected to the Ontario Legislature in 1990 at age 27, Arnott’s service earned him re-election on seven occasions. He became the 42nd speaker of the Legislative Assembly of Ontario in July 2018 following his re-election. Once the youngest member of Provincial Parliament in the Ontario Progressive Conservative Caucus, Arnott is now the longest serving member of the Legislature.
Jamie West, Member of Provincial Parliament of Ontario | Co-Chair West’s legislative career launched in 2018 when he was elected to the Legislative Assembly of Ontario. An advocate of the working class, he’s the official opposition critic for labor, training and skills development in the Legislative Assembly. In addition to West’s commitment to preserving human rights, his career includes work in mental health, construction, mining and workplace safety.
CSG MIDWEST
Michigan Sen. Roger Victory | Chair Victory served in the Michigan House for six years before he was first elected to the Michigan Senate in 2018. He is the Senate Republican Whip and previously served as the assistant majority whip for the 101st Michigan Legislature. In 2022, Victory served as majority vice-chair of the Senate Agriculture Committee and chair of the Senate Judiciary and Public Safety Committee.
CSG SOUTH
South Carolina Sen. Thomas Alexander | Chair Alexander started his career in South Carolina Senate in 1994. In 2021, he was voted Senate president with bipartisan support. He currently serves on several committees within the Senate, including finance; labor, commerce and industry; public utility review; and medical affairs. He also serves as chairman of the Senate Interstate Cooperation Committee, Legislative Oversight Committee and Interstate Cooperation Committee.
CSG WEST
California Assemblymember Mike Gipson | Chair Gipson has served in the California State Assembly since 2014 after getting elected by its 64th Assembly District. He has been reappointed Assembly Democratic Caucus Chair every year since 2016. In this role, Gipson leads the majority caucus’ legislative decision-making process, addresses statewide issues, and hosts weekly meetings concerning the caucus’ priorities. He previously served as a councilmember for the city of Carson.
Among the bills lawmakers passed in 2022, some notable trends emerged across the states. According to FiscalNote, the biggest policy issues that state legislatures dealt with last year fall into the areas of health, labor and employment, and education. These broad trends in legislative focus coincide with a few policy choices made in several states. Looking at specific policies, The Council of State Government conducted a scan of state legislation that revealed multiple states enacted bills in 2022 on daylight savings policy, consumer privacy, reproductive health care, paid family leave and gender-affirming health care. This does not include all trends in state legislation but does highlight areas of common interest in multiple states.
Please note: CSG is a nonpartisan organization and takes no position on state legislation or laws mentioned. CSG provides unbiased research that is based on evidence-informed and objective analysis.
These graphics appeared in Capitol Ideas Magazine (2023, Issue 1). To view current and past issues, click here.
A message from Mike McCabe, CSG Midwest Director, 1985-2023
Dear Friends,
As a new biennium begins and with this year’s legislative sessions now well underway, 2023 also marks a time of transition and new beginnings, both for the Midwestern Legislative Conference and here in the CSG Midwest office.
Led by Michigan Sen. Roger Victory, a new team of officers is guiding the work of the MLC, and soon, new executive committee members and leaders of the MLC policy committees will assume their duties.
These transitions serve as an annual reminder to me of just how fortunate The Council of State Governments is to be led at both the regional and national levels by an ever-evolving cast of dedicated individuals — leaders who willingly devote countless hours of their time and energy to promoting excellence in state government.
After almost 38 years at CSG, I continue to be inspired by the leaders and members whose shared commitments to public service and government excellence are the lifeblood of our organization.
And, as I retire, I am so grateful for the privilege I have enjoyed to work closely with so many outstanding leaders and public servants during my tenure as director of CSG Midwest. To each of you, I extend my heartfelt thanks — for your leadership, your vision and your example, but also for your friendship, your support and your commitment to the mission of CSG.
Finally, I want to acknowledge and thank the many CSG staff colleagues — both near and far, past and present — with whom I have been fortunate enough to work along the way.
To David Adkins and the outstanding CSG national and regional staff teams across the country, as well as those who work within the CSG Justice Center and our affiliated organizations, it has been an honor and a privilege to call you colleagues while sharing with you the wonderful experience of working for CSG. I could not have found a better place to spend my career, and I am grateful to all.
And to my closest fellow staffers here at CSG Midwest (both former and current), no words can adequately express what you have meant to me through the years. It has truly been a joy to work by your side, and I will always be grateful for your friendship.
I know how lucky I am to have shared this journey with you.
Special thanks to Dr. Carolyn Orr, the MLC’s longtime agriculture policy consultant, who always made us better and who also wrapped up her work for the MLC earlier this year. And best wishes to the new director of CSG Midwest, Laura Tomaka. I could not have asked for a better successor, and I’m thrilled to know that the Midwestern Office is in such capable hands.
With Laura at the helm and an incredible team in place — Ilene, Laura K., Tim, Jon, Mitch, Derek, Jess, Jenny, Cathy and Christina — CSG Midwest remains committed to assisting leaders across the region in building a better future for our states and provinces.
Under-represented populations and minority groups see state leaders sworn in following 2022 midterms
By Trey Delida
The 2022 midterm election was historic on many fronts. From newly elected officials to landmark rulings, states across the country experienced many milestones last year.
Midterm elections are often a temperature check for how the public feels about the presiding administration. This midterm came at a culmination of special circumstances: every seat in the U.S. House of Representatives was contested, the nation endured a divisive presidential election and the world emerged from a debilitating pandemic.
Ahead of the 2022 midterms, an estimated 60% of U.S. voters believed health care, inflation, jobs and the economy, and national security were the most important issues, according to Statista.
Statista also reported a historically high voter turnout for midterm elections. An estimated 46.9% of the eligible voter population took part, but that figure did not top 2018’s record-holding midterm turnout of 49.4%.
The 2022 midterms also proved successful for underrepresented populations. People of color, LGBTQ+, women and other minority groups won many key races, expanding representation in public office.
Newly elected Arkansas Gov. Sarah Huckabee Sanders, once a press secretary for former President Donald Trump, became the first female elected to the role in state history. Florida Rep. Maxwell Frost became the first Afro-Cuban and first born member of Generation Z elected to serve in Congress. Maryland Gov. Wes Moore made history as his state’s first Black governor. His running mate, Lt. Gov. Aruna Miller, became the first immigrant and first Asian-American elected to statewide office in Maryland.
Among the other historic outcomes of the midterm elections were victories by two political newcomers. Rhode Island Sens. Victoria Gu and Linda Ujifusa made history as the first Asian Americans elected to their state Legislature.
Gu is a first-generation American, while her parents were raised in an island community outside of Shanghai. They came to the states for education and stayed after taking jobs at the University of Rhode Island. Gu now represents her hometown, South Kingstown, as a senator.
Before her election, Gu studied at Harvard University, obtaining a degree in economics and computer science. Although she originally had no plans to run for office, Gu’s work as a citizen lobbyist expanded her involvement with campaigns and political organizations.
“I think I’m similar to a lot of younger folks who are concerned about climate change and environmental issues,” Gu said. “Outside of my day job I was citizen lobbying, working with and managing a lot of volunteers. I found that I really enjoyed working with people who were very passionate about any kind of issue.”
Anti-Asian hate crime spiked 339% nationwide from 2020 to 2021, according to NBC News. That was a pivotal point for Gu, who, like those around her, saw the need for more representation of their community.
“When I first started talking to family friends about running, they were very enthusiastic because they saw the need for more representation, especially after everything that was happening at the beginning of COVID with the resurgence of anti-Asian sentiments and bias,” Gu said. “I guess — stereotypically — we’re the scientists, engineers or office workers but not often looked to for leadership roles. When it comes to running for office, it’s often the local parties that recruit candidates, and that pipeline has historically not included many minorities.”
It wasn’t long after Gu announced her campaign that she received an outpouring of support and encouragement from her family and community. Her campaign was also an inspiration for some. After Gu’s campaign announcement, an Asian American high school student from a town just north of South Kingston reached out to volunteer.
“She reached out on her own. She said she was really inspired and wanted to work on the campaign or volunteer,” Gu said. “She started coming out about once a week for canvassing, and that was very early on during the primary when we were essentially going door to door.”
Gu’s victory also aligns with a successful election for women across the country. Data from the CSG Center of Innovation shows that women won 34.1% of all projected state-level races and 71.5% of all projected state-level races with at least one woman on the ballot. In total, 46.1% of women incumbent candidates won reelection.
The expansion of LGBTQ+ representation in public office was furthered by the victories of Oregon Gov. Tina Kotek, Massachusetts Gov. Maura
Healey and New Hampshire Rep. James Roesener. Govs. Kotek and Healey made dual history as the first openly gay women elected in their respective states, while Rep. Roesener became the first openly transgender man to be elected to a state legislature.
The U.S. needed to elect 35,854 more LGBTQ+ individuals across local, state and national offices prior to the 2022 midterms to reach equitable representation, according to the Victory Institute, a branch of the Victory Fund organization, which is dedicated to aiding LGBTQ+ candidates get elected.
Of those LGBTQ+ candidates, Michigan Rep. Jason Hoskins made history as the first LGBTQ+ person of color elected to his state Legislature — a responsibility he does not take lightly.
“I’ve gone into a lot of spaces where I’m usually the first or the only. It can be a lot because sometimes you are speaking for all the people you represent,” Hoskins said. “If I’m going into a room, I might be the only Black person; I might be the only gay person; and certainly, I’m going into the Michigan House as being the only Black gay person. So, there are going to be times when things come up and I — and only I — might be able to speak on it. That could be a great opportunity to educate and be a voice for those who are not here or don’t see themselves here.”
Hoskins never intended to run for office despite garnering a wealth of experience in local government as a member of city council in Southfield, Michigan, and even by establishing and running the University of Detroit Mercy Law chapter of the American Civil Liberties Union. Throughout his rise in the political ranks, he didn’t believe public office was for people like him. Being both Black and gay, Hoskins never believed he could win an election. That was until he started working with Michigan’s first openly gay Senator, Jeremy Moss.
“I could see what he dealt with, and how he navigated being gay and being an elected official,” Hoskins said. “Seeing how he was able to navigate that space showed me you can be an LGBTQ elected official and be effective, respected and be able to do great work for your community. I think seeing it be possible is the main thing and then getting the support to do it.”
Running for office is challenging, especially for those who do not have connections and funds like more seasoned politicians. Now that offices across the nation have elected many officials who are a recorded first for their respective roles, the focus has shifted toward maintaining diverse representation.
Organizations like the Council of American-Islamic Relations (CAIR) help elected officials maintain a sustainable model of equity that accurately represents the population served by the official. This is achieved by aiding minority candidates with funds, volunteers and other essential resources needed to run a campaign — all of which are crucial to mobilizing and empowering minority communities.
Georgia Rep. Ruwa Romman, a political newcomer, understood the importance of these organizations as their work entails much of her background. She co-founded the CAIR Georgia chapter Georgia chapter in 2020, and also helped create the Georgia Volunteer Hub to connect volunteers nationwide to available organizational opportunities.
This year, Romman made history as the first Muslim woman elected to the Georgia House and the first Palestinian to serve in any of the state’s public offices, a feat she believed could not have occurred without a community behind her.
“I didn’t magically become a successful candidate. It took having an entire community behind me and, for the record, it wasn’t just the Muslim community,” Romman said. “The majority of people that stood with me, voted for me and helped me are not Muslim. The reason I had the confidence, tools and vocabulary to explain my unique experience is because of other Muslims who have come before me and built an infrastructure to help me.”
According to CAIR, 146 Muslim-American candidates ran for local, state and federal office positions in this past election. Of those candidates, 82 were victorious, up from 71 in 2020. With the percentage of Muslim-American elected officials rising, the pressure on people like Romman can be heavy.
“I am incredibly honored and proud to be making history,” Romman said. “It’s also a huge sense of responsibility. In addition to representing my district, I’m now representing a group of people who for a long time have not had representation at the table.”
LOOKING TO THE FUTURE
Being part of a marginalized or notoriously underrepresented group, these candidates know what it’s like to walk in that identity and what changes will be beneficial, or detrimental, to their communities.
Winning an election is just the start. Those who run for public office do so for a multitude of reasons, but at the core they want to help others. Helping others for Rep. Hoskins means making Michigan a more welcoming place to all.
“I hope what comes out of this is me making policies that really impact change here in Michigan,” Hoskins said. “I do want to make it a more open and welcoming place for everyone. I also want to make sure that we’re doing everything we can in the state to make it more economically vibrant.”
As for Rep. Romman, she hopes that in using her platform to share her experiences that she can incite the change she wanted growing up.
“I can share my experience; I can talk about — for example — the impact that public education had on me. I can talk about the importance that teachers have had in my life and how they saved my life. I can talk about the fear I had growing up because I didn’t have consistent access to health insurance,” Romman said. “I think, as a state lawmaker, people now listen to that a little bit more than they did if it was just a random millennial tweeting or posting on Instagram, Facebook or Tik Tok.”
Undeniably, the 2022 midterm elections will go down in the history books. Historic firsts swept the nation, even in unsuspecting states. Post-election results reveal that this midterm was historically close, and neither party totally dominated, leaving us all to wonder what awaits in 2024.
Period poverty is a term gaining worldwide traction in discussions of public health and gender equality. It refers to the general struggle that people face when they cannot access or afford proper menstrual hygiene products or information about their menstruation. Menstrual product shortages like the tampon shortage created by the COVID-19 pandemic, as well as the financial burden of purchasing these products, can make them inaccessible to many consumers. Currently, 22 states (Map 1) tax tampons, pads and other necessary period products at rates ranging from 4-7%. The tampon tax, in addition to rising costs of inflation, contribute to period poverty.
The Impacts of Period Poverty Period poverty impacts mental, physical and social health. The lack of menstrual products and the stigma around menstruation can cause frequent absences from school, work and other activities, causing disruptions to education and creating additional financial strain. More than four out of five teens had personally missed class or knew someone that missed class due to menstrual hygiene products being inaccessible, according to a survey commissioned in the U.S. by Thinx, a period product company, and PERIOD, a nonprofit. When people lack access to pads, tampons or other menstrual products, they may turn to unsanitary substitutes such as old clothes or toilet paper. In addition to the embarrassment and discomfort this may cause, there is potential risk of infection, further deteriorating overall wellbeing.
Period poverty is particularly pervasive for individuals in prisons, detention facilities and homeless shelters. Just 25 states (Map 2) explicitly require state prisons and detention facilities to provide free menstrual hygiene products in sufficient quantity to prisoners. Even so, these products are often of poor quality or the policies are not properly enforced, sometimes leading to the exploitation of prisoners in exchange for menstrual hygiene products.
For individuals experiencing homelessness in any capacity, hygiene – especially menstrual hygiene – becomes difficult. Access to bathrooms, clean water and privacy is limited even in homeless shelters. Hygiene product donations to shelters often do not include period products, making it hard for shelters to meet the needs of the people they serve.
Legislative Action Thirty-two states and Washington, D.C., have statutes or legislation regarding the provision of free menstrual hygiene products in schools, prisons and/or shelters. Illinois and New York currently maintain the most complete policies, as they require free menstrual hygiene products in schools, shelters and prisons statewide.
Most states requiring menstrual hygiene products in schools utilize district funding. However, policies established in states like Alabama, Colorado and North Carolina rely on grant programs. Several states have established gender-inclusive policies or updated existing policies with gender-inclusive terminology. For example, California, Rhode Island,Washington D.C., and others include gender-neutral school bathrooms as a location requirement for menstrual hygiene supplies. Alternatively, states like Arkansas require schools to make these products accessible in a central or specified location aside from bathrooms so that any student may have access.
Despite efforts by legislators and nonprofit organizations, individuals who menstruate still face daily challenges of sanitation, privacy and access to menstrual hygiene products. More comprehensive and nationwide legislation addressing taxation and provision of products, as well as thorough menstrual health education, is needed to eliminate the frequency of period poverty in the U.S.
