Vol. 49, No. 10 The Council of State Governments November/December 2006 · the council of state...

thecouncilofstategovernments www.csg.org �

Vol. 49, No. 10 The Council of State Governments November/December 2006

statenews

� statenews november/december�006

7Silver Society AwardVermont’s Choices for Care wins.

ByJackPenchoff

senior editorJackPenchoffmanaging editorMaryBranhamDusenberryassociate editorLauraColemangraphic design coordinatorJessicaDowneyproofreaderChrisPryorreprint permissions(800)800-�9�[email protected] and advertising sales(800)800-�9�[email protected](859)�44-800�[email protected]

headquartersDanielM.Sprague,ExecutiveDirector�760ResearchParkDriveP.O.Box��9�0Lexington,KY40578-�9�0(859)�44–8000

washingtonJimBrown,GeneralCounselandDirectorHalloftheStates444N.CapitolSt.N.W.,Suite40�Washington,DC�000�(�0�)6�4–5460

easternAlanV.Sokolow,Director50BroadStreet,Suite5�0NewYork,NY�0004-�3�5(��)48�–�3�0

midwesternMichaelH.McCabe,Director70�E.��ndStreet,Suite�0�Lombard,IL60�48(630)9�5–�9��

southernColleenCousineau,DirectorP.O.Box98��9Atlanta,GA30359(404)633–�866

westernKentBriggs,Director��079thStreet,Suite650Sacramento,CA958�4(9�6)553–44�3

12A Time for a ChangeChild placement compact ready for update.

ByLauraColeman

8Graying Prisons

States face challenges of an aging inmate population.

By CarrieAbner

Statement of Ownership, Management and Circulation

PublishedincompliancewithU.S.PostalServiceregula-tions.�)Title:StateNews.�)Pub.no.:�549-36�8.3)Filingdate:�0/0�/06.4)Frequency:Monthly,�combinedissues:June/JulyandNov./Dec.5)No.publishedannually:�0.6)Annualsubscriptionprice:$55.7/8)Mailingaddressofpublication/publisher :�760ResearchParkDrive,P.O.Box��9�0,Lexington,KY40578-�9�0.9)Publisher :TheCoun-cilofStateGovernments;SeniorEditor :JackPenchoff,P.O.Box��9�0,Lexington,KY40578-�9�0;ManagingEditor :MaryBranhamDusenberry,P.O.Box��9�0,Lexington,KY40578-�9�0.�0)Owner:TheCouncilofStateGovern-ments,P.O.Box��9�0,Lexington,KY40578-�9�0.��)None.��)Hasnotchangedduringpreceding��months.�3)StateNews.�4)October�006.�5)Avg.no.copiesofeachissueduringpreceding��months/No.copiesofsingleissuepublishednearesttofilingdate:A.Totalno.copies:�3,544/�4,5�7.B.(�)Paid/requestedoutside-countymailsubscriptions:��,�49/�3,�83.C.Totalpaidandrequestedcirculation:��,�6�/�3,��3.D.(3)OtherclassesmailedthroughtheUSPS:0/0.(4)Freedistributionoutsidemail:89�/944.E.Totalfreedistribution:89�/944.F.Totaldistribu-tion:�3,�54/�4,�67.G.Copiesnotdistributed:400/350.H.Total:�3,554/�4,5.I.Percentpaidand/orrequestedcircula-tion:93.�%/93.3%.�6)November/December�006.�7)Signature/titleofbusinessmanager:JackPenchoff,senioreditor,Oct.�,�006.

152006 Innovations WinnersBy LauraColeman,MaryBranhamDusenberry

andJackPenchoff

Departments

32Making “Cents” of PreventionByJamesM.HmurovichandJaneAscroft

4 Inside Story StateInnovationsAwarded ByJackPenchoff

5 Toolbox EMAPOffersFrameworkforPreparedness

6 State Sources Aroundupofrecentreportsandresources forstateofficials

7 State Snapshot StateBusinessTaxClimateIndex

35 CSG Spotlight HighlightsofactivitiesandeventsbyCSG, itsaffiliatesandotherassociations

38 Conference Calendar MeetingsandconferenceactivitiesofCSG, itsaffiliatesandotherassociations

39 Timeline Alookbackintime

29Partnership Potential

U.S.-Canadian collaboration has economic, policy benefits.

ByJenniferBurnettandMegganTaylor

Correction

The New Mexico Early Childhood Action Network (ECAN) was incorrectly identi-fied in a story about the Pregnancy Risk Assessment Monitoring System (PRAMS) in the September State News.

By Jack Penchoff

Vermonthasthesecondsmallestpopulationinthenation;Texasthesecondlargest. Vermontranks45thinlandsize;Texasisthesecondlargeststateinthenation. WhileTexashasonefootintheSouthandan-otherintheWest,there’snodoubtVermontsitssquarelyintheheartofNewEngland. Despitethosedifferences,VermontandTexas,alongwiththenation’s48otherstates,sharedacommonchallenge:howtoprovidemorehome-basedcarefortheirelderlyanddisabledMedic-aidclients. The common barrier was federal laws that allowed Medicaid only to pay fornursinghomecare. Toovercome thatobstacle, the twostates tookdifferentpaths toarriveat thesameplace. The result inbothcaseswasmoreefficientMedicaidservicesandconsumershappytohavetheirhealthcareneedsmetathome. Thetwostatesalsoshareanotherthing:bothhavereceivednationalrecognitionfromTheCouncilofStateGovernments. AnindependentpanelofjudgeshasselectedVermont’sChoicesforCarepro-gramasCSG’sSilverSocietyAwardwinner.TheawardwasanoutgrowthofCSGPresidentGov.JimDouglas’president’sinitiativeonaging.Itwasdesignedtocom-plementtheannualInnovationsAwardprogram. Texas is oneof eight nationalwinnersofCSG’s2006 InnovationsAwardsprogram. Bothstates,alongwiththesevenotherInnovationsAwardswinners,willberec-ognizedduringaspecialluncheonDec.2atCSG’sAnnualTrendsandLeadershipForuminPhoenix. ThiseditionofState NewsshowcasestheawardwinnerswitharticlesonVer-mont,theeightnationalInnovationsAwardwinnersandthefourregionalalternatewinners. AgingisalsothetopicofCSGPolicyAnalystCarrie Abner’s article,“Gray-ingPrisons,”whichreportsonhowstatesaredealingwiththegrowingnumberofelderlyinmatesinstatecorrectionalfacilities. State NewsAssociateEditorLaura Colemanreportsinthisissueonproposedchanges to the Interstate InterstateCompact for thePlacementofChildren.Thecompact,enactedbythestatesin1960,hasbeenupdatedtoincorporatesocietalandtechnologicalchangesoverthepast40years.Ohiowasthefirstandonlystatetoadoptthenewcompactthusfar.Therevisedcompactneedstheapprovalof34morestatesbeforeitcanreplacetheexistingcompact. ProtectingchildrenisalsotheissueJames M. Hmurovich,presidentandCEOofPreventChildAbuseAmerica,andJane Ascroft,directorofpublicpolicyatPreventChildAbuseAmerica,writeabout. More than870,000childrenareabusedorneglectedeachyear.PreventChildAbuseAmericafosterspartnershipswithstatestoreducethemaltreatmentofchil-dren.Astheyreport,theyoungerthechildthegreaterriskforabuse.

—Jack Penchoff is CSG associate director of communications and senior editor of State News magazine.

Executive Committee

PresidentGov.JimDouglas,Vermont

ChairSenatePresidentEarlRayTomblin,WestVirginia

President-ElectGov.BradHenry,Oklahoma

Chair-ElectRep.DeborahHudson,Delaware

Vice ChairRep.KimKoppelman,NorthDakota

2006 executive committeeMs.KayBuck,DepartmentofTecnologyandInformation,Del.•SecretaryPedroCortes,Pe.•SecretaryTreyGrayson,Ky.•Ms.KathyHill,DepartmentofEconomicDevelopment,Iowa•Sen.GaryNodler,Mo.•Ms.JodyWagner,SecretaryofFi-nance,Va.•Sen.CarolynAllen,Ariz.•AssemblymanJeffrionAubry,N.Y.•Sen.DonBalfour,Ga.•Mr.JerryBassett,Legis-lativeReferenceService,Ala.•Mr.BruceBaughman,Alabama• State Emergency Management Agency • Mr. Robert Bip-pert,Dept.ofGeneralAdministration,Wash.•Sen.WalterBoasso,La.•Rep.DanBosley,Mass.•Sen.ShaneBroadway,Ark. • Del. Anthony Brown, Md. • Sen. Kate Brown, Ore.Rep.RayBunt,Pa.•Mr.DavidByers,SupremeCourt,Ariz.•Mr.MarkCarey,Minn.•Rep.JoeCarothers,Jr.,Ala.•Sen.BarbaraCegavske,Nev.•Lt.Gov. JohnCherry,Mich.•Mr.PhilipCherry,Dept. ofNatural Resources& EnvironmentalControl,Del.•Sen. JohnChichester,Va.•MemberRussellCopeman,QuebecNationalAssembly•Sen.KevinCoughlin,Ohio•Rep.BobDamron,Ky.•Sen.BartDavis,Idaho•Sen.Bill Doyle, Vermont • Sen. Denise Ducheny, Calif. • Treas.RandallEdwards,Ore.•Sen.KarenFacemyer,W.Va.•Sen.HughFarley,N.Y.•Rep.Craig Fitzhugh,Tenn.•Rep.Rob-ertGodfrey,Conn.•Ms.BeckyHarilson,OfficeoftheSen.President,Ky.•Sen.ToniHarp,Conn.•Sen.DouglasHenry,Tenn.•AssemblymanLynnHettrick,Nev.•Sen.LindaHig-gins,Minn.•Sen.JohnHottinger,Minn.•Gov.MikeHucka-bee,Ark.•Rep.DeborahHudson,Del.•Rep.JeanHunhoff,S.D.• JudgeRobertHunter,CourtofAppeals,N.C.•Rep.ThomasJackson,Ala.•Ms.LiliaJudson,SupremeCourt,Ind.•Dr.MichaelKing,LegislativeOfficeforResearchLiaison,Pa.•ChiefJusticeJosephLambert,Ky.Sen.T.D.Little,Ala.•Rep.WardLoyd,Kan.•Sen.MichaelMachado,Calif. •Gov. JoeManchin,W.Va.•Sen. JohnMarchi,N.Y.•Sen.Pres.Ken-nethMcClintock,PuertoRico•Gov.RuthAnnMinner,Del.•Rep. JoeMiro,Del.•Rep. JeffMorris,Wash.•Rep.MikeMurphy,Ind.•Gov.FrankMurkowski,Alaska•Sen.RaphaelMusto,Pa.•Gov.JanetNapolitano,Ariz.•Sen.DaveNeth-ing,N.D.•Lt.Gov.JaneNorton,Colo.•Gov.GeorgePataki,N.Y.•Gov.TimPawlenty,Minn.•Treas.JohnPerdue,W.Va.•Gov.SonnyPerdue,Ga.•Rep.DanicePicraux,N.M.•Ms.MaryRegel,DepartmentofCommerce,Wis.•Gov.JodiRell,Conn.•Rep.RogerRoy,Del.•Sen.StanRosenberg,Mass.•Rep.Chris Ross, Pa. • Sen. Steve Saland,N.Y. • Sen.Di-AnnaSchimek,Neb.•Sen.BobSchuler,Ohio•Mr.JohnSelig,Dept.ofHealthandHumanServices,Ark.•Rep.TomSloan,Kan.•Rep.MarySkinner,Wash.•Ms.AnneSoileau,Dept.ofStateCivilService,La.•AttorneyGeneralWayneStene-hjem,N.D.•Rep.DonnaStone,Del.•AttorneyGen.PaulSummers,Tenn.•Sen.RonTeck,Colo.•Sen.DonneTrotter,Ill.•Rep.SteveUrquhart,Utah•Sen.LeticiaVandePutte,Texas •Ms. PamVarni, LegislativeAffairsAgency,Alaska •Sen.JeffWentworth,Texas•Sen.Pres.DavidWilliams,Ky.•Ms.SandraWintson,WorkforceInvestmentBoard,Ark.

STATE NEWS, 1549-3628, November/December 2006, Vol. 49, No. 10— Published monthly with combined issues in June/July and Nov./Dec. by The Council of State Governments, 2760 Research Park Drive, Lexington, KY 40511-8410. Opinions expressed in this magazine do not necessarily reflect the policies of The Council of State Governments nor the views of the editorial staff. Readers’ comments are welcome. Subscription rates— In the U.S., $55 per year. Single issues are available at $6 per copy. POSTMASTER: Send address changes to State News, Sales Department, P.O. Box 11910, Lexington, KY 40578-1910.

Advertising—Black and white, two-color and full-color ad-vertising available. For complete circulation and advertising information, contact the advertising department at (800) 800-1910. Mailing lists are available for rent upon approval of a sample mailing.

Copyright 2006 by The Council of State Governments. Periodicals postage paid at Lexington, Ky., and at additional mailing offices.

insidestorySharing capitol ideas. StateInnovationsRewarded

toolboxEMAPOffersFrameworkforPreparedness ArecentlyreleasedWhitePaperfromtheEmergencyMan-agementAccreditationProgram(EMAP)providesaframeworkforstatestousewhenassessingregionalpreparednessfornatu-ralandhuman-causedincidents. The five-step assessment methodology was developed tohelpmulti-jurisdictionalareas,bothurbanandrural,identifyemergency management capability shortfalls and opportuni-ties, benchmark progress and identify strategic priorities.Multi-jurisdictionaleffortsprovideopportunitiesforstateandlocaljurisdictionstodomorewithless,thereportsays. TheEMAPprocessshowshowastateorlocalprogramcom-parestonationalstandardsandspecifiesareasinwhichitneedstoimprove.Byachievingaccreditedstatus,anemergencyman-agementprogramdemonstratesthatitisusingitsresourcestoprovidethecapabilitiesemergencymanagersnationwideagreearenecessarytobeprepared.EMAPalso:

Provides benchmarks for program management and op-erations;

Focusesoncomprehensiveemergencymanagement;

Encourages collaboration of state- and community-wideprogramsratherthanfocusingonindividualagencies;

Enhancescontinuityofoperationsandresiliency;

n

n

n

n

Validatesprofessionalcapabilities;

Demonstrates effective use of public resources and pro-videsjustificationforresources;and

Encourages intra- and interagency communication andteam building through the assessment and accreditationprocess.

BasedonevaluationsoftheNationalCapitalRegionproject,theEMAP report proposes the following regional assessmentframeworkfordiscussionandfurtherdevelopment:

Identifyinganddefiningtheregionandprogram;

Performingself-assessmentsofregionalplansandactivities;

Performingself-assessmentsbymemberjurisdictions;

Performingregionalon-siteassessmentandtable-topexer-cises;and

Developingaregionalassessmentreport.

Thefinalstepwouldassistregionalstakeholdersinidentifyingemergencymanagementgapsandareasforfutureimprovement. ToviewEMAP’sWhitePaper,“AFrameworkforAssessingRegionalPreparedness,”initsentirety,visitwww.emaponline.org/?256.

n

n

n

n

n

n

n

n

StateEmployeeHealthCareBenefitsStudied Continuingtoprovidemedicalcoverageforretireesisama-jor concernanda significant costdriver formany states.TheNational Association of State Personnel Executives (NASPE)recently released a White Paper based on its survey of statesabouttheirhealthcarebenefitsdesign. TheNASPEsurveyfoundcertainrealitiesplayasignificantroleinhealthcarebenefitsdesign,including:

Healthcarebenefitsareexpectedwiththestate’ssizeasanemployer;

Eligibilityandcoveragedetailsmaybeinfluencedbypo-liticallyandsociallydrivenfactorsinsteadofpurebusi-nessfactors;

Benefitlevelsmaybebornofsocial,family-friendlypolicypreferences, i.e. lowercost familycoverageand/orcover-agefordomesticpartners;

StatesfacetheburdenofuncappedMedicaidexpenses,andconsequentlytendtoofferstatesponsoredemployeehealthcoveragetoextendedpopulationssuchasretireesandlocalgovernmentemployees.

TheNASPEsurveyfoundfourmajorcostfactorsstategov-ernmentsmustconsiderindeveloping,deliveringandevaluat-ingtheirhealthcarestructure:

Employercontribution;

Plandesign/structureandlevelofbenefits;

n

n

n

n

n

n

Totalcostofpremiums;and

Totalcostofout-of-pocketexpensestoemployees.

NASPE found that state governments vary widely onthosecosts. The survey report also reinforced the reality of the 20/80rule:Twentypercentof thepopulationuses80percentof thehealthcarefinancialresources.AccordingtotheWhitePaper,10percentconsume70percentoftheresourcesand5percentconsume50percent. Formoreinformation,visitwww.naspe.net.

n

n

thecouncilofstategovernments www.csg.org 5

statesources

6 statenews november/december�006

StateBusinessTaxClimateIndex(�006–�007)

U.S. 5.00 - 5.00 -

Alabama 5.47 �0 5.60 �6

Alaska 7.�3 3 7.�9 3

Arizona 5.�4 �8 5.�3 �9

Arkansas 4.88 35 4.87 35

California 4.5� 45 4.64 4�

Colorado 5.67 �4 5.70 �3

Connecticut 4.83 37 4.66 4�

Delaware 6.08 9 6.�0 9

Florida 6.86 5 6.85 5

Georgia 5.48 �9 5.5� �0

Hawaii 5.�4 �4 5.�8 �4

Idaho 5.03 3� 5.08 30

Illinois 5.�3 �5 5.�� 6

Indiana 5.79 �� 5.86 ��

Iowa 4.56 43 4.6� 44

Kansas 5.04 3� 4.99 33

Kentucky 4.76 39 4.75 38

Louisiana 5.04 30 5.05 3�

Maine 4.67 4� 4.64 43

Maryland 5.�3 �9 5.�3 �5

Massachusetts 4.88 36 4.87 36

Michigan 5.�5 �7 5.�0 �8

Minnesota 4.68 4� 4.7� 39

Mississippi 5.57 �7 5.57 �9

Missouri 5.65 �5 5.68 �4

Montana 6.�0 8 6.�6 8

Nebraska 4.53 44 4.59 45

Nevada 7.�� 4 7.07 4

NewHampshire 6.�� 7 6.45 6

NewJersey 3.9� 48 3.63 48

NewMexico 5.3� �3 5.30 �3

NewYork 4.�6 47 3.60 49

NorthCarolina 4.7� 40 4.70 40

NorthDakota 4.98 33 5.06 3�

Ohio 3.8� 49 3.8� 47

Oklahoma 5.45 �� 5.4� ��

Oregon 6.04 �0 6.0� �0

Pennsylvania 5.36 �� 5.3� ��

RhodeIsland 3.47 50 3.47 50

SouthCarolina 5.�� 6 5.�� 7

SouthDakota 7.57 � 7.56 �

Tennessee 5.49 �8 5.58 �8

Texas 6.45 6 6.4� 7

Utah 5.63 �6 5.67 �5

Vermont 4.4� 46 4.57 46

Virginia 5.68 �3 5.58 �7

Washington 5.95 �� 5.93 ��

WestVirginia 4.9� 34 4.93 34

Wisconsin 4.78 38 4.77 37

Wyoming 7.66 � 7.64 �

D.C. 4.06 - 4.4� -

�007 �006

State Score Rank Score Rank

TheTaxFoundationrecentlyreleasedthe2007versionoftheStateBusinessTaxClimateIndexasatoolforlawmakers,themedia and individuals to gauge how their states’ tax systemscompare. Thischartisacomparisonofhowstates’businesstaxclimatedidfromfiscalyear2006tofiscalyear2007.Thehigherthescore,themorefavorableastate’staxsystemisforbusiness. TheSBTCIplaces113variablesintofivecomponentindexesthateachmeasureadifferent sectorofa state’sbusiness taxclimate. The five component indexes are the Corporate TaxIndex,IndividualIncomeTaxIndex,SalesTaxIndex,Unem-

ploymentTaxIndexandPropertyTaxIndex.Thetotalscoreforeachstateiscalculatedbasedonthescoresofeachcompo-nentindex. According to the report, the 10 best states for business taxclimateareWyoming,SouthDakota,Alaska,Nevada,Florida,Texas,NewHampshire,Montana,DelawareandOregon. The 10 worst states are Rhode Island, Ohio, New Jersey,NewYork,Vermont,California,Nebraska, Iowa,MaineandMinnesota. To see the full report, visit www.taxfoundation.org/files/bp52.pdf.

�007 �006

State Score Rank Score Rank

statesnapshots


Vermont has the second fastest agingpopulation in the nation and, like otherstates,facesthechallengeoffundingMed-icaidservicesforitsoldercitizens. To address that challenge, Vermont hasembarked on a bold program that createsmorechoicesforthestateanditsMedicaidrecipients. Choices for Care is the only Medicaidprogram in the country that gives a stateflexibilityinmanagingMedicaidcare. Theprogram’sinnovativeapproachtoservingitselderlypop-ulationandexpanding services earned recognition froman in-dependentpanelof judgeswhoawardedChoices forCareTheCouncilofStateGovernments’2006SilverSocietyAward. The program was established after the federal governmentgrantedVermontan1115DemonstrationWaiver,whichallowsthe state to provide consumers greater choices in where theyreceivedcare. “Traditionally, Medicaid only had an open door to nursinghomesbutnothomeandcommunitybasedcare,”saidTheresaWood,deputycommissionerfortheVermontDepartmentofDis-abilities,AgingandIndependentLiving. “We responded to what consumers’ choices are and that isapreferenceforhome-basedcare.Andthestatewantstopre-parefortheadventofbabyboomersandaburgeoningMedicaidpopulation,” said Wood. “It’s a win-win for the state and theconsumers.” WhilethewaivergivesVermontgreaterflexibilityinmanag-ingthecareofitsMedicaidrecipients,italsoplacesgreaterriskonthestate.Inexchangeforthewaiver,thestateagreedtocapfederalMedicaidfundingforthenextfiveyears. Vermontlaidthefoundationforthisnewprogramduringthe1997-98legislativesession.That’swhenlegislatorspassedalawthatdirectsanysavingsfromlowernursinghomecostsberedi-rectedtohome-andcommunity-basedservices. “That’srevolutionary,”saidWood,“tohaveastateadminis-trationandlegislatureagreetolanguagelikethat.Itwasoneofthefirstinstanceswherethemoneyfollowstheperson.” Early indicationsare that theprogram isachieving itsgoals,savingmoneyonnursinghomeplacementsandusingthesavingstoexpandservices. Inthefirstyearoftheprogram,whichendedSept.30,2006,therewere156fewerconsumersinnursinghomes,accordingtoWood.

“The resources from those fewer people in nursing homesserveddoublethenumberwewouldhaveservedinhome-basedandenhancedresidentialcare,”shesaid. “Ordinarilyweserve100newpeopleeachyear.Thesavingsenabledustoserve205.” Developing the program not only required the collaborationofstategovernmentofficials,italsoneededthehelpofnursinghomeproviders. WoodandLorraineWargo,directorofthedepartment’sIn-dividualSupportUnit,believeotherstatescanadoptasimilarstrategy. “We had a task force that brought everyone to the table,”saidWargo. Thetaskforcespenttwoyearslookingatlong-termcareissuesanddevelopingtheChoicesforCaremodel. “Thereareconcernsfromnursinghomeproviders,”saidWar-go.“It’s important toget thoseplayers to the tableearly.Theyhavetobetherewithyou,” It was also important to have community-based services inplace.“Theyneedtobethere.Youhavetoprovideanalternative,”saidWargo.

By Jack Penchoff

Vermont’s Medicaid Program Stats �45,000 Covered Lives—�5 percent of Vermont’s

Population

5�,�00Children—34percentofVermont’sChildren

$9�0 Million in FY �006 Total Medicaid Expendi-tures

LargestInsurerinVermont—9,000EnrolledProviders

n

n

n

n

Vermont’s Choices for Care Wins


States Face Challenges of an Aging Inmate Population

Elderly inmates represent the fastest growing segment of federal and state prisons. The aging inmate population has created new challenges for states.

By Carrie Abner

PrisonsGRAYING


Atage89,Earl takessixpillsadayandcarriesabottleofnitroglycerinpillswithhimatalltimesincasehehasaheartattackorstroke.Hisfingersareshriveledwitharthritisandhe’shadcataractsurgerythreetimes.Hejustreceivedawheelchairtohelphimgetaround. From outside appearances, Earl may seem like most otherelderlymeninAmericawithagrowinglistofage-relatedail-ments.Butwhilemanyofhispeersresideinnursinghomesandassistedlivingfacilities,EarlwilllikelycallWisconsin’sOsh-koshCorrectionalInstitutionhomefortherestofhislife. Earlrepresentsagrowingnumberofelderlyinmatesinstateprisonsacrossthecountry.Asthispopulationcontinuestorise,statesaretakingnote.

Elderly Inmates: A Growing Trend AccordingtotheU.S.JusticeDepartment’sBureauofJusticeStatistics,theU.S.prisonpopulationhasgrownfromjustover319,000in1980tonearly1.5millionin2005. Elderlyinmatesrepresentthefastestgrowingsegmentoffed-eralandstateprisons.A2004reportbytheNationalInstituteofCorrectionsstatesthatthenumberofstateandfederalprisonersages50andolderrose172.6percentbetween1992and2001,fromnearly42,000tomorethan113,000.Someestimatessug-gestthattheelderprisonerpopulationhasgrownbyasmuchas750percentinthelasttwodecades. Expertssaythegrowthoftheelderinmatepopulationisex-pectedtocontinue.AccordingtoJonathanTurley,alawprofes-soratGeorgeWashingtonUniversityanddirectoroftheProjectfor Older Prisoners, the population of prisoners ages 50 andolderinthefederalsystemgrewfrom11.3percentofthetotalprisonpopulationin1986to26percent in1989.Headdsthateven conservative estimates suggest that this population willrepresent33percentby2010. Whysuchadramaticincreaseintheolderprisonerpopula-tion?Expertspointtoanumberofreasons. First,theriseinolderprisonersreflectsthegeneralagingofsociety.In2003,therewereanestimated36millionindividu-alsage65orolderintheUnitedStates,comprisingjustover12percentofthetotalpopulation.AccordingtotheFederalInter-agencyForumonAging-RelatedStatistics,theolderpopulationgrewfrom3millionto35millioninthe20thcentury. Officialsalsopointtotheget-tough-on-crimereformsofthe1980sand1990sas contributing factors to thegrowingnum-bersofolderprisoners.Mandatoryminimumsentences,three-strikesrulesandtruth-in-sentencinglawsestablishedinrecent

decadesarekeepingmoreoffendersinprisonforlongerperiodsof time.And inmatesare living longer,meaningprisonscon-tinuetoswell.

Tending the Elderly Behind Bars: The Challenge for States For states, the challenges associated with an aging prisonerpopulation are real and growing, yet statistics on the numbersofelderlyinmatesaredifficulttoproject.Thisisdueinparttovariations in the definitions states have established for elderlyprisoners. For instance, while Ohio defines elderly inmates asthoseaged50andolder,Minnesotasetstheageat55.Michiganconsidersthose60andaboveaselderly,whileinColorado,thisdesignationisreservedforinmates65andolder.Otherstateshavenoofficialagedesignationfortheelderlyprisonerpopulation. What’smore,inmatestendtoagefasterthanmembersofthegeneralpopulation.Researchindicates thataprisoner’sphysi-ologicalage is,onaverage, seven to10yearsolder than theirchronologicalage.Therefore,a50-yearoldinmatemaylikelyexperiencetheage-relatedhealthproblemsofa60-yearoldontheoutside. Dr. David Thomas, who chairs the Department of Surgeryat Nova Southeastern University and previously directed theFloridaDepartmentofCorrections’OfficeofHealthServices,recallsoneofhisfirst encounterswitholder inmates.Havingmetaprisonerhethoughttobe70to75yearsold,hewassur-prisedtolearnthattheinmatewasjust54. “Inmatesappearedtobephysicallyandmedicallyolderthantheiractualage,”hesaid. Thomasandotherspointtoanumberoffactorscontributingtothisphenomenon,includinglackofaccesstohealthcareser-vicespriortoentry,poordietaryandexercisehabits,andsub-stanceabuse. A2000studybytheFloridaDepartmentofCorrections’Of-ficeofHealthServicesfoundthatalmosttwo-thirdsofinmatesreceivedtheirfirstsignificanthealthcareexperience,definedasanysurgeryorfilledandstartedprescription,whileinprison. Stressalsocontributes toacceleratedagingamonginmates.“The stress of incarceration—including lack of support sys-temsandalackoftrustinfellowinmates—leadstochronicallystressfulanddebilitatingenvironments,”saidThomas. Asa result, older inmates tend todevelopage-relatedhealth

“”

Prisons aren’t geared to the needs and vulnerabilities of older people. In the prison environment, there are a number of unique physical tasks that must be performed every day in order to retain independence. They’re not the same tasks that are called for in the community.

—Brie Williams, M.D. Geriatrician at the San Francisco VA Medical CenterGRAYING

�0 statenews november/december�006

Thestudyof120elderlyfemaleprisonersinCaliforniafoundthat69percentreportedthatatleastoneactivityofdailylivingwasverydifficulttoperform.Sixteenpercentreportedthattheyneededassistancewithatleastonedailyactivity,representingtwicetherateofthegeneralU.S.population65orolder. In many cases, inmates rely on younger prisoners to getaround. Forsomeelderlyprisoners,however,thegeneralprisonpopu-lationcanbethreatening.TheNICcitesvulnerabilityofabuseandpredationanddifficultyinestablishingsocialrelationshipswithyoungerinmatesassomeofthespecificchallengesassoci-atedwithanagingprisonerpopulation. Accordingtoa2004NICreport,“thelackofpersonalprotec-tion for elderly inmates, who may be frail and therefore vul-nerabletothethreatsofassaultbyyoungerpredatoryinmates,contributes to the emotional stress and physical deteriorationtheyroutinelyexperience,especiallyamongthosewhomaybealreadyvulnerableowingtochronicorterminalillnessandwhohavefewoptionsforchangeintheirenvironment.”

States React: Programs and Policies for an Aging Prison Population Acrossthecountry,statesarebeginningtotakestepstoad-dresstheimplicationsofanolderprisonpopulation.Fromde-velopingtargetedprogramsandactivitiesforelderlyinmatestoproviding specialized geriatric care, state corrections depart-ments aredevotingan increasingamountof attentionand re-sourcestotheneedsofseniors. Ina2001surveybytheCriminalJusticeInstitute,approxi-mately15ofthe44participatingstatesandterritoriesindicatedthattheyprovidedsupervisedrecreationalprogramsspecifical-lydesignedforolderandelderlyinmates.Andotherstateshaveestablishededucationalprogramsonwellnessandagingissuesaspartofanoverallpreventivecareprogram. Ohio’sHockingCorrectionalFacilityoffersa“50+andAg-ing”program,which isdesignedtoaddress thephysical,psy-chologicalandsocialneedsofolderinmates.Suchactivitiesaschairaerobics,adultbasiceducationandGEDclassesarepro-videdaspartoftheprogram,aswellasspecializedrecreationaloptions,includingbingo,shuffleboard,horseshoesandawalk-ingprogram.CasemanagersalsoprovideassistancetoelderlyinmatesapplyingforSocialSecurityandMedicarebenefits. Pennsylvaniahasalsoprovidedinmatehealthcareeducationprograms,andhasevenofferedahealthyheartfoodline,featur-inglowfat,highfiberfoodsforinmates. Specializedhousingforelderlyinmatesappearstobeanothertrendinthestates.Atleast16statesprovideseparatehousingfacilitiesforolderprisoners;insevenstates,thesehousingunitsarereservedforelderlyinmateswithspecialmedicalneedsorforthoseotherwiseeligibleforhospicecare. TheMinnesotaCorrectionalFacilityatFaribault,amedium-securityfacilityforadultmales,hasadedicatedhousingunitforinmates55 andolderwith chronichealthproblems.Licensedpracticalnursesprovidecoverage16hoursadayandaroundtheclocknursingisofferedinaclinicarea. Some states that do not have designated geriatric units havespecified“chronicinfirm”bedsdedicatedtoolderoffenders.Andapproximatelyhalfthestatesofferhospicecareforinmates.

problemsearlier.AccordingtoTurley,anelderlyinmatewillex-perienceanaverageofthreechronicillnessesduringhisorherterm.TheNationalInstituteofCorrectionslistsarthritis,hyper-tension,ulcerdisease,prostateproblemsandmyocardialinfarc-tion among the most common chronic diseases among elderlyinmates.Diabetes,HepatitisCandcancerarealsocommon. Thefinancialburdenforstatesinprovidingadequatehealthcareforolderprisonersisstaggering.In1997,theTexasCrimi-nalJusticePolicyCouncilreportedthathealthcareforelderlyinmatesran$14.80perday,nearlythreetimesthehealthcarecostsforyoungerprisoners. While a younger prisoner costs approximately $22,000 tohouseannually, statespayanaverageof$67,000peryear forolderinmates. And as the aging prisoner population grows, the costs forstatesareexpectedtorise.ExpertsestimatedthatannualcostsforprovidinghealthcaretoelderlyinmatesinTexascouldin-creasefrom$27millionin1999to$56millionin2008. In addition to the rising health care costs, the aging pris-onerpopulationpresentsadditionalchallengesfor thestates,including general accommodations and protection againstyoungeroffenders. Liketheelderlypopulationoutsideprisonwalls,olderinmatesneedspecialadaptivedevicestohelpovercomephysicalimpair-ments.Formanyelderly,walkers,canes,hearingaids,eyeglasses,denturesandgeriatricchairsarenecessarytofunctionwell. Beyond meeting the general needs of an aging population,however,statesmustalsoaddressthespecificneedsoftheag-ingpopulationinprisonsettings.Oneoftheprimarychallengesfor states is adaptingprison facilities thatoriginallywerenotdesignedwithelderlyresidentsinmind. “Prisonsaren’tgearedtotheneedsandvulnerabilitiesofold-erpeople,” saidBrieWilliams,MD,ageriatricianat theSanFranciscoVAMedicalCenterandleadauthorofarecentstudyonagingfemaleprisoners.“Intheprisonenvironment,thereareanumberofuniquephysicaltasksthatmustbeperformedeverydayinordertoretainindependence.They’renotthesametasksthatarecalledforinthecommunity.”

lease)hastobeputbackintothepost-releaseplan.…It’snotthatexpensive todothat.But itcanbe thedifferencebetweenzerorecidivismandgreaterrecidivism.It’scalledasoftlanding.”

Looking Ahead AsAmerica’sprisonerscontinuetogrowolderandsicker,thecoststostateswillcontinuetorise.Whilestatesarebeginningtoaddresstheneedsofanincreasinglyagedprisonpopulation,expertswarnthatmoreplanningmustbeundertakentoavoidapotentialcrisisdowntheroad. “Statesmustprepareinthebudgetaryprocesstospendmoreonanaginginmatepopulation,”warnedThomas.Headdsthatfundingrequirementsforthespecializeddietsandhealthcarenecessaryforolderprisonersmustbeconsidered. Someofficialsalsoprojectthatstatesmayreconsidersentenc-ingpoliciesthatkeepoffendersinprisonforlongertermsinanefforttocurbprisongrowth. Asstatestrytofindpolicyoptionsforanever-growingnum-berofelderlyinmates,prisonerslikeEarlcontinuetogetolderandsicker,requiringmorecare.Tomitigatecoststotaxpayersinthefuture,statesshouldplannow.

—Carrie Abner is a senior policy analyst for Public Safety and Justice at The Council of State Governments.

StateandFederalInmatesAge50+(1992 – 2001)

Source of Statistics: Anno, B. Jaye, Camilia Graham, James E. Law-rence, and Ronald Shansky. Correctional Health Care: Addressing the Needs of Elderly, Chronically Ill and Terminally Ill Inmates. U.S. Department of Justice/National Institute of Justice. 2004.

�99� 4�,586

�993 44,30�

�994 50,478

�995 55,�8�

�996 63,004

�997 73,543

�998 83,667

�999 9�,36�

�000 �03,�3�

�00� ��3,358

Year Inmates Year Inmates

At Angola State Penitentiary in Louisiana, once known asthebloodiestprisoninAmerica,deathamonginmates isnowoftendue tonatural causes.Facing a fast-growingpopulationof elderly inmates, Angola is one ofmany prisons across thecountrythatoffershospicecareforinmatesinthefinalstagesofterminalillnesses.Fellowinmatesbuildcoffinsandprovideburialservicesforthosewhodieinside. Afewstateshaveevendesignatedprisonsforolderinmates.Since 1996, Pennsylvania’s State Correctional Institution atLaurel Highlands has been housing only elderly inmates andotherswhorequirelong-termcareorassistedliving.Convertedfromastatementalhospital,thefacilityisdesignedtomeettheneedsofanolderpopulation,includinglong-termcareinmatesandwheelchairusers. Some officials argue that offering specialized facilities forolder inmatesandthechronicallyillreducesthecostsassoci-atedwiththeircare,includingmedical,employmentandtrans-portationcosts. “Specializedcampsprovideeconomiesofscalefortheprovi-sionoftargetedservices,”saidThomas.“Medicalcare,handicapfacilities, specialized diets and specialized exercise regimensare all easier to providewhen elderly inmates are in a singlelocation.” Headdedthatspecializedfacilitiesalsoexperiencefewerdis-ciplinaryproblems,asolderoffendersaremoreprotectedfromvictimizationbyyounger,moreaggressiveinmates.

Let them go? Debatearoundtheagingprisonpopulationhasevenextendedbeyondtheprisonwalls.Acrossthecountry,correctionsprofes-sionals, academics andpolicymakers are consideringwhethersome older inmates should be released through medical andearlyreleaseprograms. Anumberofstateshavecompassionatereleaseprogramsinplace for terminally ill inmates, but some experts claim thattheseprogramsarerarelyused,due tobureaucraticandotherobstacles. In Georgia, some elderly inmates have been released undermedicalreprieve,asupervisedreleaseprogramforinmateswhoare considered low-risk for re-offending. Proponents for thisapproachargue thatonce released, inmatesmaybeeligible forMedicare,SocialSecurityorveteransbenefits,relievingaportionofthestates’financialburdenfortheircare. Officialscaution,however, thatanycost savings fromearlyrelease must be weighed against public safety risks and mustconsiderthetransferofcoststootherstateprograms. “Although corrections may reduce costs through early re-lease, thecost to taxpayersdoesn’tnecessarilygoaway,”saidCarl Wicklund, executive director of the American ProbationandParoleAssociation. With little savings and limited employment opportunities,elderlyoffendersmaynotbeabletoadequatelycareforthem-selves. As a result, said Wicklund, “society may still be bur-denedbythecostsforcaringforanoffender,eventhoughheorshemaynolongerposeathreattothecommunity.” Othersagree,andadvocatethatsomecostsavingsassociatedwithearlyreleaseprogramsbeused toassistwith thecommu-nity re-entry transition.Testifyingbefore theCaliforniaSenatein2003,Turleywarnedthat“someofthatmoney(fromearlyre-

problemsearlier.AccordingtoTurley,anelderlyinmatewillex-perienceanaverageofthreechronicillnessesduringhisorherterm.TheNationalInstituteofCorrectionslistsarthritis,hyper-tension,ulcerdisease,prostateproblemsandmyocardialinfarc-tion among the most common chronic diseases among elderlyinmates.Diabetes,HepatitisCandcancerarealsocommon. Thefinancialburdenforstatesinprovidingadequatehealthcareforolderprisonersisstaggering.In1997,theTexasCrimi-nalJusticePolicyCouncilreportedthathealthcareforelderlyinmatesran$14.80perday,nearlythreetimesthehealthcarecostsforyoungerprisoners. While a younger prisoner costs approximately $22,000 tohouseannually, statespayanaverageof$67,000peryear forolderinmates. And as the aging prisoner population grows, the costs forstatesareexpectedtorise.ExpertsestimatedthatannualcostsforprovidinghealthcaretoelderlyinmatesinTexascouldin-creasefrom$27millionin1999to$56millionin2008. In addition to the rising health care costs, the aging pris-onerpopulationpresentsadditionalchallengesfor thestates,including general accommodations and protection againstyoungeroffenders. Liketheelderlypopulationoutsideprisonwalls,olderinmatesneedspecialadaptivedevicestohelpovercomephysicalimpair-ments.Formanyelderly,walkers,canes,hearingaids,eyeglasses,denturesandgeriatricchairsarenecessarytofunctionwell. Beyond meeting the general needs of an aging population,however,statesmustalsoaddressthespecificneedsoftheag-ingpopulationinprisonsettings.Oneoftheprimarychallengesfor states is adaptingprison facilities thatoriginallywerenotdesignedwithelderlyresidentsinmind. “Prisonsaren’tgearedtotheneedsandvulnerabilitiesofold-erpeople,” saidBrieWilliams,MD,ageriatricianat theSanFranciscoVAMedicalCenterandleadauthorofarecentstudyonagingfemaleprisoners.“Intheprisonenvironment,thereareanumberofuniquephysicaltasksthatmustbeperformedeverydayinordertoretainindependence.They’renotthesametasksthatarecalledforinthecommunity.”

lease)hastobeputbackintothepost-releaseplan.…It’snotthatexpensive todothat.But itcanbe thedifferencebetweenzerorecidivismandgreaterrecidivism.It’scalledasoftlanding.”

Looking Ahead AsAmerica’sprisonerscontinuetogrowolderandsicker,thecoststostateswillcontinuetorise.Whilestatesarebeginningtoaddresstheneedsofanincreasinglyagedprisonpopulation,expertswarnthatmoreplanningmustbeundertakentoavoidapotentialcrisisdowntheroad. “Statesmustprepareinthebudgetaryprocesstospendmoreonanaginginmatepopulation,”warnedThomas.Headdsthatfundingrequirementsforthespecializeddietsandhealthcarenecessaryforolderprisonersmustbeconsidered. Someofficialsalsoprojectthatstatesmayreconsidersentenc-ingpoliciesthatkeepoffendersinprisonforlongertermsinanefforttocurbprisongrowth. Asstatestrytofindpolicyoptionsforanever-growingnum-berofelderlyinmates,prisonerslikeEarlcontinuetogetolderandsicker,requiringmorecare.Tomitigatecoststotaxpayersinthefuture,statesshouldplannow.

—Carrie Abner is a senior policy analyst for Public Safety and Justice at The Council of State Governments.

AverageHealthCareCostperInmate(1991 – 2000)

Source of Statistics: Anno, B. Jaye, Camilia Graham, James E. Law-rence, and Ronald Shansky. Correctional Health Care: Addressing the Needs of Elderly, Chronically Ill and Terminally Ill Inmates. U.S. Department of Justice/National Institute of Justice. 2004.

�99� $5.04

�99� $5.6�

�993 $5.90

�994 $6.07

�995 $6.53

�996 $6.59

�997 $6.97

�998 $6.86

�999 $7.34

�000 $7.39

Year DailyAverage

TheProjectforOlderPrisoners

Foundedin�989,theProjectforOlderPrisoners(POPS)wasdesignedtocombatprisonovercrowdingandassistaginganddisadvantagedprisoners.Sinceitsestablishment,POPShasprovidedguidancetomorethan500prisoners,andhasconductedresearchonlegislativereformatthenationalandstatelevels.FormoreinformationaboutthePOPSprogram,visitwww.gwu.edu/~ccommit/law.htm.

Year DailyAverage

�� statenews november/december�006

Alothaschangedsince1960. In thepast40years, the legal systemhasevolved to includeadministrative law provisions; technology has become an in-dispensablepartofeverydaylife,frombusinessandresearchtoentertainment;andtheinterstatehighwaysystemhasprovidedaseamlesswayforpeopletotravelacrossthecountry. Atleastonething,however,hasremainedthesame:theInter-stateCompactforthePlacementofChildren. Draftedin1960,thecompactistheonlypubliclawthatensureschildrenplacedacrossstatelinesforfostercareoradoptionareplacedwithsafeandsuitable families.About532,000childrenarecurrentlyinout-of-homeplacements,and5.5percentofthoseare interstate placements. Sixty-one percent of children placedacrossstatelinesarepermanentplacements. In itscurrent form, theICPChascausedunnecessarydelaysandtheprocessdoesn’ttakeintoaccounttechnologiesdevelopedafter1960,saysJohnMountjoy,directoroftheNationalCenterforInterstateCompactsatCSG.

The current Interstate Compact for the Placement of Children was enacted by the states in 1960. Many child welfare stakeholders say the compact is outdated and it’s time for change.

By Laura Coleman

TIMEA

for Change

Child Placement Compact Ready for Update

thecouncilofstategovernments www.csg.org �3

“Ithinksinceitwasdevelopedmorethan40yearsago,ithasn’tbenefitedfromadvancesinsociety,”hesaid.“Theinterstatesys-temwasnew,therewasn’ttheabilitytoshareinformationovere-mailandfax,andtherewasn’tthevolumeofcasesweseenoweither.Itwasdevelopedforaparticulartime.Itjustneedstobeupdated so it can take advantage of the things that now exist:transportation,informationsharingandmodificationstoadmin-istrativelawandenforcements.” Butwiththesupportofstates,arevisionofthecompactcouldbeinplacesoon. InMarch2004,TheCouncilofStateGovernmentsandthestatehumanserviceleadershipoftheAmericanPublicHumanServicesAssociation(APHSA)adoptedapolicyresolutiontoremedythesedeficienciesoftheoldcompact.Theyassembledadraftingteamofhumanservicesadministrators,stateandlo-calchildwelfaredirectors,compactadministrators,andrepre-sentativesfromnationalorganizationstorewritethecompact. The team finished the drafting process in April 2006. OhioenactedthenewcompactinJune,butitneedsthesupportof34morestatestoreplacethecurrentlaw.

What’s the Difference? The ‘Old’ Compact Theexistingcompactincludesacompletehomestudybythereceivingstate.Thereceivingstateassessescriteriasuchasthesocialandmedicalhistoriesoftheplacementfamily,theirback-grounds,parentinganddisciplinestyles,employmentandfinan-cialhistories,andprofessionalandpersonalreferences.Thatstatealsoconductsaphysicalevaluationofthehomeandcriminalandchildabusebackgroundchecks.Ifallthoseassessmentsaread-equate, theplacement isdetermined tobe“notcontrary to thewelfareofthechild.” APHSAadministers the compact, but the agency is not cur-rentlyauthorizedbythecompacttoenforceitsrules.Inaddition,since1960stateshave“filled in theblanks,”unilaterally inter-pretingthecompact,changingthestatute,processandproceduresforinterstateplacements.Inotherwords,thereisnolongeracom-monagreementamongthestates. Remedyingtheenforcementmechanismiswhatthenewcom-pact is about, says Mary Ball Morton, compact administratorfromDelawareforboththeICPCandtheInterstateCompactforthePlacementofJuveniles.“Idon’twanttomislead,”shesaid.“Ithinktheintentionsandmeatofthecurrentcompactdotherightthing,butitneedsthatstrongerenforcementpiecetobeaconsis-tentlyworkingtool.”

The ‘New’ Compact TheproposedICPCprovidesasolidlegalframeworkforen-suring the timely placement of children cross state lines, thesuitabilityofprospective families, and theprovisionofneededsupport services.Theupdatedversionwascomposedbymanystakeholders,includingstatehumanserviceadministrators,stateand local child welfare directors, compact administrators andrepresentativesfromnationalorganizationsliketheUnitedStatesDepartmentofHealthandHumanServicesandtheChildWel-

fareLeagueofAmerica. ToRobinArnold-Williams, the acting chair of theproposedcompactunderAPHSA,thecomplexnatureofthechildwelfaresystemwarrantedinvitingavarietyofstakeholderstothetable. “Thereisawholevarietyofverystronglyheldopinionsonev-erythinginchildwelfare,”shesaid.“Theproposeddraftreallydoestrytotakealookateverybody’sviewsonthingsandtriestocomeupwithwhat’sbestforchildrenandfamilies.” The new draft of the compact specifically addresses detailssuchaswhothecompactappliesto,jurisdiction,theassessmentprocessandenforcement.

Applicability The draft of the proposed compact does not cover childrenplacedbytheirparentsintoresidentialtreatmentfacilities,witharelativeorwithanon-relativeaslongasthatplacementisnotaninitialsteptoadoption.Itdoesnotapplytoforeignadoptions. Residential facility placements require that the sending statenotifythereceivingstate.Thecurrentcompactrequiresapprovalbythereceivingstatepriortosuchplacements. Thedraftincludesallplacementsmadeasapreliminarysteptoadoption,whethertheyaremadebyapublicorprivatechildplacingagency,aprivatepersonoranattorney.

Jurisdiction Under theproposed language, jurisdictionmeans theauthor-ityof thecourtsand judicialofficers to takeanddecidecases.Thelanguagealsoaddsthreecircumstancesinwhichthesendingstatecourtwillhaveauthoritytoterminatejurisdiction:

Ifguardianshipiscreatedinthereceivingstatewithagree-mentofthesendingstate.

Ifatribehaspetitionedforareceivedjurisdictionfromthecourtinthesendingstate.

Ifthechildisreunifiedwiththeparentinareceivingstateandtheparent is subjectofallegationsorfindingsofabuseandneglect.Thisrequiresconcurrenceofthereceivingstate.

Assessments Thedraftdefinesassessmentasthe“evaluationoftheprospec-tive placement to determine whether the placement meets theindividualizedneedsof thechild, including,butnot limited to,thechild’ssafetyandstability,healthandwell-being,andmental,emotionalandphysicaldevelopment.” According to the compact’s current language, the receivingstatemustonlydetermine that theplacement“doesnotappearcontrarytotheinterests”ofthechild.

Enforcement Thedraftofthecompactprovidesformediationandbindingdisputeresolution,remedialtrainingandspecifictechnicalas-sistance. It alsoprovides for judicial actionbymember statesoftheInterstateCommission,whichitalsocreates,toenforcecompliance. TheInterstateCommissionwouldbecomprisedofonevot-

n

n

n

for Change


ingrepresentativefromeachmemberstate.Thatrepresentativewouldbeappointedbytheexecutiveheadofthestatehumanserviceadministrationwhohasultimateresponsibilityforthechildwelfareprogram. Inaddition,thelegalframeworkofthecompacthasironedoutsomeofthekinkstheoldcompactneglected,saidMountjoy. “Ratherthanhavingtogobacktoeverysinglesigningstatelegislature every time you need to make changes, the legalframeworkallows that tohappenwithin the rules. It’smuchquicker,muchmoreresponsivetothechangingworldandhowtheplacementofadoptiveandfosterkidsishandled,”hesaid. “The whole structure of the compact came as part of theInterstateCompactforJuveniles,”saidArnold-Williams. The ICJ has been adopted by 30 states and addresses themanagementmonitoring,supervisionandreturnofjuveniles,delinquentsandstatusoffenderswhoareonprobationorpa-roleandwhohaverunawayfromtheirsentencingstates. “Wearegoingtohavetoexplaintolegislaturestohelpthemfeelcomfortablewiththerule-makingbeingdonewithICPC,”saidArnold-Williams.“Theyobviouslymusthavebeencom-fortablewiththatbecauseofICJ,sotheyshouldbecomfort-ablewithICPC.” To Ball Morton, there is a relationship between the twocompacts. “Ifwe’vekeptachildhereinDelawareandwedidn’thavetherightplacement—itcouldbearesidentialtreatmentneedorbeingwithafamilyelsewhere,butsomethingdifferentthanwewouldbeabletofindhere—thechildmighthavetomovearound a lot, go from home to home to home here in Dela-ware,”shesaid.“Ifyouhavethesemechanismstofindplacesinother statesandcanuse thecompact, ensure supervision,I’m sure itwould save somechildren fromendingup in thejuvenilejusticesystem. “The juvenile compact sends children back to their fami-liesandensurestheygetprobationservices,”BallMortonex-plained.“WhatwetrywithICPCistohavethemnotevengettotheprobationlevel.Wehelpthemfindwhattheyneed,evenifit’sinotherstates.”

Keeping the System From Failing Mountjoylikestothinkofacompactprojectasthreestages. “The first stage is exploratory, the second is education andadoption,andthethirdistransitioningtothenewagreement,”hesaid.“Wesentoutfinalcopyofthenewcompactandasurveythataskedifstateswouldsupportthecompactinitscurrentformwithnochanges.Thirty-sevenof40statessaidtheywould.Itgivesusgreatpromisegoingintothe2007legislativesessions.” Mountjoysaidonce35statesjointhecompact,thelanguageoftheoldcompactwillbeusedforatleast12months.“Onceyougetthere,thenewinterstatecommissionmaydecidetolengthenthattime,”hesaid. Butwhatabout thestates thatwerepartyto theoldcompactthatchoosenottojointhisone? Afterthe12-monthperiod,thenewcompactruleswilltakeef-fectandwillonlyallowthenewmemberstodobusinessamongthemselves.Statesthathavenotjoinedthenewcompactafter12months after it hasbeen signedby the35th statewill havenomeaningfulway toplace children innewcompact states.Thatmeanstheywillhavenowaytopreventstatesfromsendingchil-drenwithoutpermissionornotice. “Allplayerswillbe interested ingooddiscussions.Andwehad that sittingarounddiscussingandbuilding thenewcom-pact,”saidArnold-Williams.“Itnecessitatedcompromise,andthatwillplayoutagaininstatelegislatures.Allstakeholderswillhavetodiscussiftheycanaccepttheprovisionswesetforth.Itshouldhavethosegooddebates,butIamveryoptimisticwecangetitdone.” “Thesystemhasbeenbrokenforsolongthatwejustcan’taf-ford tohavekids fall through thecracks,”saidMountjoy.“Wecan’taffordforplacementstobedelayed.Whatwe’reconcernedaboutisthekids.It’saboutcreatingandpromotinganewsystemthatwillpositivelyimpactachild’soutcome.” BallMortonagrees. “We’re talkingaboutchildrenhere, andwe’retalkingaboutfolkswhoneedtohavetimelyplacement.”

—Laura Coleman is the associate editor for State News magazine.

“”

The system has been broken for so long that we just can’t afford to have kids fall through the cracks. We can’t afford for placements to be delayed. What we’re concerned about is the kids. It’s about creating and promoting a new system that will positively impact a child’s outcome.

—John MountjoyDirector of the National Center for Interstate Compacts

TolearnmoreabouttheInterstateCompactforthePlacementofChildren,visitwww.csg.org/programs/ncic.


Itwas,perhaps,theworld’sbiggestmudpie. IllinoisstateofficialsapprovedthemudslingingonChicagoslagfields—allinanefforttoreturndisplacedsoiltothelandonLakeMichigan. The pilot project—Mud to Parks—is gaining national at-tention,andgarneredIllinoisaCSGInnovationsAwardfortheMidwestregion. “We’vegotarealresourceatthebottomoftheriver,”saidLt.Gov.PatQuinn.“Ifweuseourheadsandcommonsense,wecanhelptheriverandatthesametime,helpotherpartsofourstateandcountry.” Theslagfieldthatservedasapilotprojectwasthe573-acreU.S. Steel South Works redevelopment site on the south sideofChicago.Quinnhashighhopestheprogramcanbeusedinotherareas,andsaidthestateisintalkswithLouisianaofficialstotakesomeofthefertileIllinoissoiltothemarshlandsthere. MudtoParkswasthebrainchildofDr.JohnMarlin,aseniorscientistwiththeWasteManagementResearchCenter,adivi-sionoftheIllinoisDivisionofNaturalResourceslocatedattheUniversityofIllinois. “LikemostoftheMidwest,Illinoishasalwayshad,andprob-ablyalwayswillhave,aproblemwithsedimentfillinginreser-voirsandbackwatersonrivers,”Marlinsaid.

Marlin had worked as a student with professors who hadmodestsuccesswithusingdredgematerialastopsoilnexttoPeoriaLake. “Thebigproblem,”hesaid,“isthefarmlandissofertilenexttothelakethefarmersdon’tneedorwantadditionalmaterial.” “There’senoughmudinPeoriaLaketofillafootballfield10andahalfmileshigh,”hesaid.“It’shardtoplaceitlocally.” Butupstream168miles,Chicagohadan industrial sitewithvery little soil. To recover that land using traditional methodswouldhavemeantmanytruckloadsofsoilscrapedofffarmlandandconstructionsiteswouldhavetotravelthroughurbanareas. Marlin’splanwas todredgePeoriaLakeand ship themudbybarge.Buteventhatwouldrequirenewtechniques.Dredgematerialistypically90percentwaterand10percentsolid,soMarlinsaidthehydraulicdredgingtechniquewouldn’twork. “Whatwe’vebeen lookingat arehigh soliddredging tech-niquesthatbringupmudratherthanasoupymixture,”hesaid.Usingthatmechanicaldredgingtechnique,Marlinsaid,work-erswereabletoget“puremudoutofthelakeinsteadofalittlebitofmudmixedwithwater.” That mud, with a consistency of pudding, was shipped bybargedirectlytotheChicagoslagfield,whereitwasplacedinmining trucks and taken to the site. There it went through aprocess of weathering and movement. After a few months, abulldozerspreadthesoiltwotofourfeetdeep,andtheareawasseededwithryegrass. Todaytheareaisfilledwithplantlife. “Weessentiallyreclaimedthatareabyslabbingmudalloverit,”Quinnsaid. Quinn’s office in 2004 granted $75,000 to WMRC for theproject.HegotinvolvedafterhearingMarlin’spresentation.Hesaiditrequiredachangeinhowdredgematerialisconsidered. “Whatareyourresources?”hesaid.“Coaloroilorsoybeansorcorn.Wehaveallofthose,butmaybe,rightbeforeourveryeyes, is a resourcewe’veoverlooked fordecades.Wehave todealwiththelegacyofsedimentationatthebottomoftheriver.Ifwecanusecommonsenseandingenuity,wecanhelpalotofourcountrybuildparks,domanypositiveenvironmentalthingswiththisresource. “The Illinois River mud is the best you can find,” he said.“Ourmudisyourtreasure.” TofindoutmoreaboutMudtoParks,visitwww.wmrc.uiuc.edu/index_sections/about_us/2005_annual_report/mud_to_parks.htm.

Illinois River Mud Builds Chicago ParkBy Mary Branham Dusenberry

midwest

FastFacts MudtoParkswascreatedtoaddresssevere

sedimentation on the Illinois River and itsbackwaterlakes.

Theprogramtakesadisplacedresource—mudinthebottomofthewaterways—andmovesittoaplacewhereitcanbeused—suchasaChicagoparkonLakeMichigan.

The lieutenant governor’s office granted$75,000totheWasteManagementResearchCenterforprogramstartupcosts.

The program is funded through grants andgeneralresearchfunds.

n

n

n

n

thecouncilofstategovernments www.csg.org �7 thecouncilofstategovernments www.csg.org �7

InoneKansascounty,a5mg tabletofZyprexacost$5.18.Thatsametabletwouldcost$11.14inanothercounty. ThatwasbeforeKansasstateandcountyofficialsgottogethertopurchaseprescriptionmedicinesinacollaborativeeffort. “Pharmaceutical costs for jail inmates and state prisonerswerebecomingabudgetbusterforthestateandcounties,”saidRandall Allen, executive director of the Kansas AssociationofCounties.“Wecametogetheratthetablearoundacommonneed.…Thereweredataavailabletodescribethedevastatingfinancialimpactofhighercosts.” In December 2004, the Kansas Department of Correctionsnegotiatedwithitscontracthealthcareprovider,CorrectCareSolutions,toofferbulkpharmaceuticalpricingtostateandlocalgovernmentsthroughCCS’spharmaceuticalprovider,DiamondPharmaceuticals. Whilethestatehasseennofinancialgain,accordingtoVi-olaRiggin, contract consultantwith theKansasDepartmentofCorrections, theprogramhassavedmore than$7millionacrossthestate,withsmallruralcountiessavingasmuchas$6,000 a month and larger metropolitan areas saving morethan$200,000amonth.Theprogram—theKansas Pharma-ceutical Collaborative—willbe recognizedwithaCSGIn-novationsAwardfortheMidwestregion. Betsy Gillespie, director of the Shawnee County Jail, saidthereare95countyjailsinKansas“andthereisnocentralizedsystemforcountyjailstotalktoeachotherandhavesomeonewhocanprovideadvice.” EnterTeamTechInc.,aKansas-basedconsultingfirm. KathleenHarnish-Doucet,aTeamTechfacilitator,saidGov.KathleenSebeliuswantedtostreamlinestategovernment. “Allservicesreallyarelocalandifyouweregoingtotrulystreamlinegovernment,youhavetoworkthroughthestatetothelocallevel,”Harnish-Doucetsaid. It was at the first state-county Health and Human ServicesSummitthatofficialspickedaprojecttodemonstratecollabora-tiondoeswork.Countyrepresentativesdiscussedtheever-risingcostofprovidinghealthcaretoinmates,accordingtothestate’sInnovations program application. The population of prisonerswithmentalhealthissueshasincreasedsignificantlyinthepastfewyearsduetotheclosingofastatementalhospital,accordingtoAllen. MarkZilner,CEOofDiamondPharmaceuticals, saidsomeKansascountieshaveseensavingsupto60percentoverpricingatlocalpharmacies.

Butthatsuccesswouldn’thavehappenediftherightpeoplehadn’tbeenatthetablefornegotiations. “There’swaytoomuchhistoryonhavingthecountyandstateinadversarialroles,”Gillespiesaid.Shecreditsthegovernorforsettingthetonefordiscussion. “Whenthistookoffwaswhenthestategotupfromthechairsaroundthetablesandthecountiessatdownandthestategaveassistance,”saidJoelWright,ateamfacilitatorwithTeamTech.“Alotofpeoplehadtovisualizetheirrolesdifferently,”saidJohnWaltner,specialprojectsdirectorforHarveyCounty,Kans. Harnish-Doucet said for a successful collaborative govern-menteffortwithinthestate,“you’vejustgottogetoutandmeetpeople.” Rigginsaidakeywasgettinginformationoutaboutthesuc-cessoftheprogram.Zilnersaiditwasnota“highpressuresale”tothecounties,buthiscompanydidacostanalysisandprovidedcountieswiththeinformation.Somecountyofficials,skepticalatfirst,eventuallysigneduptoparticipate. Waltner,whoisalsomayorofHesston,Kans.,saidtheCol-laborative“seemstopointtoawaylocalgovernmentscangetgoodinformationtomakegooddecisionsthathavetodowiththespecificthingsthey’redealingwith.” Harnish-Doucet said thestatewill lookatotherareaswherestateandlocalgovernmentscanworkinacollaborativemanner. To learnmoreabout theKansasPharmaceuticalCollabora-tive,visitwww.accesskansas.org/.

Kansas, Counties Collaborate on Drug PurchasesBy Mary Branham Dusenberry

FastFacts TheKansasPharmaceuticalCooperativehas

savedthestate’slocaljailsmorethan$7mil-lion since itwas implemented inDecember�004.

The Cooperative uses the state’s bargainingpowerwithaprivatecontractortonegotiatesavings to smaller agencies (state and localgovernments).

The program requires no additional fundingatthestateorlocallevel.

Coloradohas adopted themethodanduti-lizedtheKansasDepartmentofCorrectionsbidstructuretoofferthesamediscountstoitslocalgovernments.

n

n

n

n

�8 statenewsnovember/december�006

Minnesota Uses Design Build-Best Value for Road Project MinnesotahitthetrifectawithitsROC52roadproject. “Usually in the triangleofsafety,qualityandcost,youcanpicktwoofthethree,butyoucan’thaveallthree,”saidTerryWard,ROC52projectmanagerwiththeMinnesotaDepartmentofTransportation.“Wewereabletodeliverallthreewithover-whelmingpublicsupport.” Thestateusedadesignbuild-bestvaluedeliverymethodinits11 Miles in 1,000 Daysreconstructionprojectof11milesofhighwaynearRochesterandtheworld-renownedMayoClinic.Highway52,nicknamedROC52becauseitrunsthroughRoch-ester,istheprincipleroutebetweenRochesterandtheTwinCit-iesofMinneapolisandSt.Paul. “It cuts right through the heart of the Rochester commu-nity,”Wardsaid.“It’sreallytheeconomicengineofsoutheast-ernMinnesota.” Theprojectwasneededtoreducecongestion,improvesafety,replacedeficientbridgesandpavementandeliminatethecon-fusingmixedfrontageroadsystem,accordingtothestate’sap-plicationfortheCSGInnovationsAward. Ward said the project was originally set up for completionin11years through15stages.But,hesaid,basedonfunding

alternate

andthenewdeliverymethod,theprojectwascompletedwithinthreeandahalfyears. TheDesign-Buildmethodspeedstheprojectbyallowingcon-structiontostartsoonafterthedesignisbegun,insteadofwait-ingforfulldesigncompletion.Italsosavesmoney,accordingtoMinnesota’s Innovations application, when future inflationarycostsarefactoredintheanalysis. Thetotalprojectcost$239million.ItmarkedthefirsttimeMinnesotausedtheDesignBuild-BestValueapproach. Wardsaidsomeoneconcernsomestateshaveisthatnonlocalornontraditionalcontractorswilltakebusinessfromthelocalcontractingcommunity. “Ourcontractorusedlocalmaterials,localcontractorsandlo-callabortocompleteROC52,”hesaid.“Itlookedverysimilartoatraditionaldesignbuildprojectasfarascompaniesworkontheproject.” To learn more about 11 Miles in 1,000 Days, visit www.roc52.com/.

—Mary Branham Dusenberry

Photo Credits: Photos of the planning groups for the Kansas Pharmaceutical Collab-orative on pages 17 and 18 were provided by Kathleen Harnish-Doucet, a TeamTech facilitator for the state. Photos of Illinois Mud to Parks Program, pictured at different stages in the process on the magazine cover and pages 17 and 18, were pro-vided by Dr. John Marlin, a senior scientist with the Waste Management Research Center.


WhenapersonisarrestedinKentucky,itislikelythatthear-restingofficerwillaskhimthreecriticalquestionstoassesstheneedfortreatmentformentalillness. That’s just thefirststep inKentucky’s Jail Mental Health Crisis Network, administered by the state’s Department ofMentalHealthandMentalRetardationServices.Theprogramboastsan80percentreductioninsuicidesinKentuckyjailsdur-ingfiscalyear2006. ItisoneofeightnationalwinnersofCSG’sInnovationsAwards. Theprogram,whichbeganinJuly2004,involvesafour-stepprocesstoclearlydefineprotocolsforintegratingmentalhealthservicesintostatedetentioncenters,saidConnieMilligan,re-gionaldirectoroftheprogramanddirectorofintakeandemer-gency services for Bluegrass Regional Mental Health-MentalRetardationBoard.MilliganandRaySabbatine,aconsultanttothementalhealth-mentalretardationboardandaformerjailerinLexington,helpeddeveloptheprogram. First,anarrestingofficeradministersaquestionnairerelatedtobehavioralindicatorsofsuicide,mentalillnessornegativere-actionstothearrestee’scharge.Theanswerstothesequestionscanwarrantan immediatecall to theTelephonicTriageLine,describedbelow.Thebooking/screeningofficerthenadminis-tersasecondquestionnaire. Theavailabilityofatoll-freeTelephonicTriageLinethatof-fers24-hourresponsebylicensedmentalhealthcareprofession-als at Bluegrass Regional Mental Health-Mental RetardationBoard is thesecondcomponent.Amentalhealthcareprofes-sionalusesamentalhealthandsuicideriskassessmentinstru-menttoidentifyalevelofriskrelatedtocurrentandpotentialredflagsforsuicidalthoughtsormentalillness. “Thetriagedoesariskassessment,thendeterminesariskratefortheinmate,”saidRitaRuggles,theprogram’sadministratoratKentucky’sDepartmentofMentalHealthandMentalRetar-dationServices. Thatriskrateistiedtojailhousingandmanagementproto-cols.Triageprofessionalsthencontactacommunityhealthcareproviderwhomustrespondwithinacertainamountoftime.Forexample:

Criticalrisklevel:Anindividualisactivelytryingtotakehislife.Four-pointrestraintsarenolongeracceptablebe-causeofsafetyrisks.Alocalmentalhealthcareprovidermust respond within three hours to evaluate the personface-to-face.

Highrisklevel:Alocalmentalhealthcareprovidermustrespond within 12 hours. Safe or single-cell housing isusedalongwithfrequentsupervision.

Moderate risk level: A local mental health care providermustrespondbythenextbusinessday.Theindividualcanbe placed in general housing but will receive individual-izedobservationtodetermineifhedevelopssymptomsthatneedfurtherassessment.

Lowrisklevel:Theindividualcanbehousedinthegeneralpopulation.

Rugglessaidinfiscalyear2006,therewere8,989callstothetriagelineand45percentofcallsindicatedaneedforface-to-faceevaluation.In75percentofcalls,thepersonexperiencedatleastonesymptomofmentalillness. Milligansaid45percentofpeoplewhoreceivedaphoneas-sessmentalsoreceiveface-to-faceassessment. “Iftheyneedfollow-upservices,theyareencouragedtogoforthem,”shesaid.Milligansaidtheprogramwilleventuallyevolvesoclinicianswilldevelopareleaseplanforthoseindividuals. Approximately80percentof jails in thestateparticipate inthenetwork. TheJailMentalHealthCrisisNetworkiseasilytransferabletootherstates,Rugglessaid. “Wecouldactuallysetupthis1-800linetobeanationallinesothecosttoreplicatetheprograminanotherstatewouldbetopayfortheirserviceontheline,”shesaid.“Thenthestatewouldhave tohave theavailabilityofmentalhealthprofessionals toprovidegroundresponseatthelocallevel.” Formore informationontheJailMentalHealthCrisisNet-work,visithttp://mhmr.ky.gov/kdmhmrs/default.asp.

n

n

n

n

Kentucky Program Cuts Suicide Rate in JailsBy Laura Coleman

southern

FastFacts: Implementedbylegislativeactionin�004to

cut downon suicides in Kentucky’s jails andprovide better services for arrestees withmentalillnesses.

Programcosts:$�.�millionannually.

Fundedbya$5increaseincourtcostsinbothdistrictandcircuitcourts.

Aspartof theprogram,mentalhealthpro-fessionals go into jails toprovide services toarrestees.

n

n

n

n


SinceTexas’ Money Follows the Personprogramcameintoeffectfourandahalfyearsago,thestate’sresidentshousedinMedicaid-certifiednursingfacilitieshavemoreoptions. “MoneyFollowsthePersonisanopportunityfornursingfa-cilityresidentstoaccessMedicaid-basedcommunity-basedpro-grammingwithouthavingtogoonawaitinglist,”saidMarcS.Gold,managerofthePromotingIndependenceInitiative.“Peo-plecangohomeandthestatewillpayforservicestobebroughttotheirhomeorintoassistedlivingoradultfostercare.” Goldsaidthereasontherearewaitinglistsisbecausebydefi-nition,nursingfacilityservicesareanentitlementunderMedic-aid.Community-basedcare,however,isnotanentitlement.TheprogramgarneredTexasoneofeightCSGInnovationsAwards. “Statescanlimitthenumberofcommunityplacementsiftheychoose.Thenpeoplegoonwaiting lists toget those typesofservices,”saidGold.“Thisprogramallowsmoneyallocatedfornursingfacilities togowiththemwhentheyleavetheinstitu-tionalsetting.” In 2001, Texas’ legislature attached a rider to the Depart-mentofHumanServices’appropriation.Then,inthefollowingthreeyears,stateofficialsdevelopedrulesandpoliciesfortheprogram and received a grant from the Centers for MedicareandMedicaidServices todevelop transition teams to identifyobstaclestotransitionanddevelopsolutions.In2005,the79thlegislativesessioncodifiedthebillandtheconceptswererein-forcedbyexecutiveorder. FromSept.1,2001,throughDec.31,2005,10,156individualshavetransferredfromnursingfacilitiesintothecommunity.Ofthatnumber,5,597individualsremaininthecommunity. “Thishashadatremendousimpactontheagingpopulation,with approximately two-thirds of the transferred populationoverage65,”GoldwroteinhisapplicationfortheInnovationsAward.“Therearesignificantnumbersofpersonsintheir80sand90sandeven12residentsover100whohavetransferred.Ofmajorimportistheconceptofsystemchange.Texasisaleaderintherebalancingofitslong-termcare.”

This program is cost-neutral for Texas, said Gold. MoneyFollowsthePersonisfundedthroughcurrentMedicaidappro-priationsandtookjustthreemonthstoimplement.Providingsupplemental services, such as relocation specialists to helpidentifynursingfacilityresidentswhowanttotransfer,costs$1.3millionannually. “IthinkwewontheawardbecauseasIpointedoutduringourpresentation,thiswasanewidea.Itgeneratedwidespreadsupport among advocates, consumers and government offi-cials,”saidGold.“Ithashadanimmediateimpactinqualityoflifeforagingindividualsorthosewithphysicaldisabilities.Italsohelpedpromoteotherpublicpolicy-supportedinnova-tion and is one of the bases for the federal law of the samenature.” AccordingtoGold,statesseekingtoimplementpolicieslikeMoneyFollowsthePerson,mustconsider:

TheoccupancyrateofMedicaid-certifiednursingfacilities.

Having theappropriate1915(c)waiverorotherMedicaidcommunity-basedprogramsinplace.

Thestate’shomehealthprovidernetwork.

Identifyingandcollaboratingwithappropriatestakeholders.

Financingconcerns.

Resistancebynursingfacilityproviders.

Thedevelopmentofsupportiveservices,suchasrelocationspecialistsandcommunitycoordinatinggroups.

“Weareveryproudoftheprogram.It’sdefinitelykickingoffstrong,”saidGold.“It’sbecomepartofourpublicconscious-nessinTexas;it’sbecomeoldhatbecauseweassumeit.Ithelpsgetpeoplebackintothecommunitybecausethatisthefutureoflong-termcare.” FormoreinformationontheMoneyFollowsthePersonpro-gram,visitwww.dads.state.tx.us/business/pi/index.html.

n

n

n

n

n

n

n

Texas Program Helps Medicaid Patients Stay HomeBy Laura Coleman

FastFacts MoneyFollowsthePersonhasallowed�0,�56

individuals from �00�-�005 to move fromnursingfacilitiesintothecommunity.

The program allows money allocated forMedicaid-based nursing facilities to apply toMedicaid-basedcommunityprogramming.

Costs of community-based programs areabout�0percentlessthaninstitutionalcosts.

n

n

n

North Carolina Program Brings Immigrants in Compliance Whenastateexperiencesa400percentincreaseinimmigra-tionina15yearperiod—andalargeportionofthepercentageareillegalimmigrants—chancesare,thatstateislosingrevenuethroughunpaidtaxes. EnterNorthCarolina’sGuest Worker Compliance Program,administered by the state Department of Revenue. It was se-lectedasanalternateintheSouthregionforCSG’sInnovationsAwards. Theprogramworkstoeducatethepublicabouttaxpoliciesandcompliancewithrevenue laws.Theprogram’smaincom-ponentsincluderecruitingbilingualemployees,translatingkeyinformation,publicoutreachandeducation,andenforcementofrevenuelaws. “Weworkverycloselywithcommunity-basedorganizations.Whatwe’retryingtodohereisenforcethelaws,andwhenyou’redealingwithtaxespeoplearefocusedonmoneyandwhat’sbe-inglostandgained,”saidAlanFelton,NorthCarolinaassistantsecretaryofrevenueandtaxcompliance. “Butwelookatitasanefforttobringimmigrantsincompli-ancewithU.S.andNorthCarolinalaw.WetrytotargetareasliketheCatholicchurch,statefairandseminarstogetourmes-sageout,”hesaid.“Wedon’tgetinvolvedwiththeimmigration

statusbutwhatwe’resayingis,ifyouliveinNorthCarolinaandworkinNorthCarolina,youhaveataxobligationandwearegoingtoenforcethat.” Theprogramhasrecentlygone livewithaminidataware-house. “We’vealreadyuncoveredlotsofdatathatwillshowlotsofcomplianceproblems,”saidFelton. Heofferedthisexample:Underfederallawscontractworkersgetpaidby1099forms.However,manyimmigrantsarepaidby1099s,butdonothaveSocialSecuritynumbers.Withinforma-tionlikethis,theminidatawarehousehasuncoveredmorethan$300millioninloststaterevenuethroughuntaxedincome. “Wefoundonepersonwhowaspaidamillionandhalfdol-larswithnotaxespaid,”saidFelton.“Andweneverwouldhaveknownitwithoutthedatawarehouse.” Theprogram,whichbeganin2004,coststhestate$500,000annually, and is funded through abudget allocation from theGeneralAssembly. FormoreinformationontheGuestWorkerCompliancePro-gram,visitwww.dornc.com.

—Laura Coleman

alternate

thecouncilofstategovernments www.csg.org ��

�� statenews november/december�006

Inmoststates,whenfamiliesapplyforgovernmentservices,theyfilloutnumerousapplications,answerduplicatedquestionsandspendmoretimethannecessary.TheUtah Clicks/Univer-salApplicationSystem(UAS)hasmadethisprocessmorecus-tomer-friendly. Theprogram,whichwas launchedstatewide inMay2005asapartnershipbetweenUtahStateUniversityandthestatedepartmentof health, provides access to aWeb-based intra-agencyapplicationprocessdesignedtohelpfamiliesapplyformultipleprograms. By filling out an online application, families can apply forprogramssuchasMedicaid,WIC,CHIPandHeadStart.Be-causeUASallowsfamiliestocompleteandsubmitpaperworkonlineformultipleprograms,theneedtovisitmultipleofficesisminimized.Theapplicationisavailable24hoursaday,sevendaysaweek,andisavailableinEnglishandSpanish. ForLoisBloebaum,themanageroftheReproductiveHealthProgramattheUtahDepartmentofHealth,aprogramlikethiswasadreamcometrue. “Ninetypercent of the credit goes toUSU.Wehadbeendreamingthatwouldn’titbegreatifwomencouldaccessanapplication from their homeorbusiness computersorpub-lic libraries where they could do this quick screening pro-cessonlineandfacilitateearlierentrytoprenatalcare,”she

said.“Thescreeningprocessasksfamiliesquestionsthataresharedbynumerousprogramsso theydon’thave tofilloutfourapplications.” AdrienneAkers,seniorresearcherforUtahStateUniversity,saidfamilies indicatedthat theydidn’tknowwhere toget theservicestheyneeded,andthisprovidedtheimpetusforchange. “Familiessaidthattheycallprogramsdifferentthingsindif-ferentstates,theycouldn’tgetoutofworkwhentheofficeswereopen,”shesaid. Akerssaidthefederalgovernmentrecognizedfamilies’strug-gleswiththeseissues,andofferedgrantssostatescouldworkfromwithinforaremedy.Theinitialgrantprovided$150,000ayearforfouryears.ApproximatelyhalfthefundswentintothedevelopmentoftheUtahClickstechnology. Akerssaidtheprototypefortheprogramissoundforseveralreasons. “Ourswasdoneatareasonablylowpriceandourswassuc-cessful,” she said. She said that the creators of the softwareexercisedgoodprinciplesofsoftwaredevelopment.“Theyauto-matedthosepartsoftheprocessthatmadesenseasopposedtoautomatingalltheparts,”shesaid.“Theydidn’ttrytoremovethehumanelementalltogether. “Wefoundoutthat55percentofpeopleapplyingsaidtheyareapplyingfromhome,”saidAkers.“Ifyoulookatnationalstatis-tics,thenumberofpeoplewhohaveInternetaccessisgrowing.EverybodyknowshowtousetheInternet.” OntheapplicationfortheInnovationsAward,Akerssaid97percentofusersindicatedtheywouldrecommendUtahClickstootherfamilies,contributingtothesuccessofpromotingtheprogramonlythroughword-of-mouthandnewspaperarticles. Bloebaumsaidwhiletherewerechallengesinimplementa-tion, she thinks theprogramwouldbe easily transferable tootherstates.TexasandPennsylvaniaalsoofferonlineapplica-tionprocesses. “Ithinkthatwehavesortofbeenthetrailblazersandworkedoutalotoftheprocess,soIcandefinitelyseeit,”shesaid. TolearnmoreaboutUtahClicks,visithttps://utahclicks.org/index.cfm.

Utah Clicks to Make Applications SimplerBy Laura Coleman

western

FastFacts UtahClicksallowscitizenstouseanonlineap-

plicationtoapplyforgovernmentservices.

Services like Medicaid, WIC and Head Startparticipateintheprogram.

Start-up costs for the program were fundedthroughafederalgrantthatallocated$�50,000annuallyforfouryears.

n

n

n

Betterquality,lesscost. That’s what Washington experienced after it implementedthe Spoken Language Brokered Interpreter Services inJanuary2003.TheprogramearnedWashingtononeofeightnationalCSGInnovationsawards. ThomasR.Gray,managerof theOfficeofTransportationand Interpreter Services, said the program—which providesinterpreterservicesforWashington’sestimated160,000Lim-itedEnglishProficientMedicaidclients—hassavedthestate$1millionamonth. Themovetoimplementa“brokered”servicealsosavedtheprogram.Graysaidthelegislaturehadcuttheprogramfromitsproposedbudget,butreinstateditafterthenewmodelwasproposed. “Wesavedmorethandoublewhatwewererequiredtosaveunderthelegislation,”Graysaid.“Inthefirstsixmonths,weweresupposedtosave$2.6million,andwesavedover$5mil-lion.Inthefollowingbiennium,weweresupposedtosave$12millionandwesavedover$24million.” The interpreter service was moved within state govern-ment, which implemented a brokerage model similar to thestate’s medical transportation service. That means the inter-preterservicesarescheduledthroughabroker,whichservesasa“gatekeeper,”Graysaid.Thebrokerreviewsrequestsforamedicalinterpreter,aswellastheservicesrenderedtoensurethestate’sMedicaidprogramisbilledcorrectlyforservices. Beforethisprogrambeganin2003,medicalproviderswouldcontactanagency,whichwouldsendaninterpretertothepro-videratthetimeoftheMedicaidclient’sappointment.Thebillwouldbesubmitted to theagency,whichwould thensubmitthebilltothestateforpayment. “Aninterpretercouldgeneratealotofbillsanditcouldgothroughthesystemwithoutappropriateoversight,”Graysaid.“Therereallywasnogatekeeperfunctioninpayingthebills.Weweredoingprepaymentreview.Youcanonlycallmedicalproviderstoverifysomanyappointments(beforeitbecomesaburdenforthem). “Basically, there were a lot of extra billings being gener-atedthatwedidn’tbelievewereappropriate,”Graysaid.“Theamountofchargesseemedtobeexaggerated.” ThebrokersnowensurethattheclientsservedthroughtheprogramareMedicaidclients,andthatthebillingissubmittedcorrectly,accordingtoGray.Thesamecallcenterinfrastruc-turebrokersusedcoversboththemedicaltransportationandinterpreterservices,cuttingcostsforbothprograms,hesaid.

Graysaidthenewsystemallowsforsanctionsofinterpreters“iftheydoanythingwedon’tbelieveisappropriate.Wehaveabuilt-inmechanismtomonitorthequalityoftheservicestomakesurethey’reappropriate.” Thebrokeralsocanincreaseresourcesbyrecruitingmoremedical interpreters. That’s important, Gray said, becauseWashingtonhas longbeena top relocation spot fornew im-migrantstotheU.S. “Wereallybelieveinthismodelbecauseit’sreallyworkedforus,”Graysaid. He said other states have contacted Washington to gatherinformationabouttheprogram.Grayrecommendsotherstatesconsidering interpreter services for Medicaid clients shouldmake sure there is a gatekeeper function. “Make sure theservicesarehighqualityandareprovidedappropriately,”hesaid. Washingtonrequiresmedicalandsocialserviceinterpreterstobecertified,throughastatetestingservice. “The federal law says you have to ensure effective com-munications,”Graysaid.“Todoitjustbecauseofthatlimitstheprogram.Thereal issue iswhenpeopleunderstandwhatthey’rebeingtoldmedically,webelievewegetbettermedicaloutcomes. “We also believe we will save more money,” he said. “Ifpeoplehavebettermedicaloutcomes,they’renotgoingtotheemergencyroomasmuch.We’renotpayingoutunnecessarymoneyformedicalcare.Itreallyisthebestofallworlds.” TolearnmoreabouttheSpokenLanguageBrokeredInter-preterServices,visithttps://fortress.wa.gov/dshs/maa/Inter-preterServices/.

‘Brokers’ Save Washington Interpreter ServicesBy Mary Branham Dusenberry

FastFacts TheSpokenLanguageBrokeredInterpreter

Servicesestablishedstrictcontrolsover thescheduling process for medical interpreterservices.

Washingtonistheonlystatetousea“bro-keragemodel”forprovidinginterpreterser-vicesforMedicaidclients.

TheSpokenLanguageBrokeredInterpreterServiceshasincreasedquality,loweredcosts,decreased complaints and is considered amodelforthedeliveryofotherservices.

n

n

n

Oregon Schools Strive for Energy Efficiency Oregondidn’thaveastick,soitusedacarrot. “InOregon,eachschooldistrictpassesabondmeasure tobuildaschool,”saidBettyMerrill,managerofBuildingTech-nologieswiththeOregonDepartmentofEnergy.“Thereisnocentralapproval.” Sincethestatecouldn’trequireuseofbetterenergyef-ficient systems (the stick), it offered a carrot: the High Performance Schools Program—which provides educa-tion, grants and free technical assistance toK–12 schooldistricts for the design and construction of high perfor-manceschools. Notonlydotheseschoolssave20percentmoreenergythana standardbuilding, “becauseof the integrateddesignpro-cess,theschooldistrictendsupwithaschoolthathasmoredaylighting,betteracousticsandimprovedindoorairqualitysoitenhancesthelearningenvironment,”Merrillsaid. ThestateDepartmentofEnergyprovides$50,000grantstoschooldistricts,aswellastechnicalstaffwhoworkwithdis-trictsoneverything fromorientationof thebuildingonsite,determiningusesofdifferent spaces in thebuildingand the

alternate

useoftechniquesandmaterialstoenhancethesustainabilityfeaturesinthebuilding. Merrill said states interested in a similar program shouldadoptagoalofdevelopinghighperformanceschoolsstatewide. InOregon,12schoolsdesignedandconstructedHPS,andMerrillsaid14moreschoolswillbebuiltinOregon,providedthatdistrictsapprovethebonds. Sustainablebuildings,Merrillsaid,areimportantforschooldistricts.“Ifyourutility ratesare ratchetingup10percentayear,itcanmakeahugedifference,”shesaid. TheaverageefficiencyabovecodefortheHPSinOregonisabove30percent,withoneschool reporting itsefficiencyas53percentabovecode,accordingtotheprogram’sInnovationsapplication. “It’safiscalissue,”Merrillsaid.“Youcanputthemoneyintoelectricbillsoryoucanputthatmoneyintoclassrooms.” FormoreinformationontheHighPerformanceSchoolsPro-gram,visitwww.oregon.gov/ENERGY/.

—Mary Branham Dusenberry

Photo Credits:Photos of Washington’s Office of Transportation and Interpreter Services and the call center for the state’s Spoken Language Brokered Interpreter Services, on pages 22 and 23, are courtesy of Tom Gray, chief of the office.

thecouncilofstategovernments www.csg.org �5 thecouncilofstategovernments www.csg.org �5

eastern

WhentroubledfamilieswalkintotheNew Haven Regional Children’s Probate Court, they are entering a system dedi-catedtodealingwiththeiruniqueproblems. Thecourtisamodelofinterbranchcooperationamongtheex-ecutive,judicialandlegislativebranchesofConnecticutstategov-ernment.ThatcollaborationearnedthecourtrecognitionasoneofeightnationalwinnersofCSG’s2006InnovationsAwards. Theprobate court system inConnecticut operatedwith thesamestructurefor300years.Nearlyeverytownhasanelectedprobate court judge to handle general estate proceedings andan increasing case load of guardianship and custody matters.That’s123separatecourts. Thingsbegantochangein2003whenCaseyFamilyServices,aprogramoftheAnnieE.CaseyFoundation,conductedastudyofthestate’sprobatecourtsystem. Thestudyconcludedthattherewerefewsupportandmentalhealthservicesforfamiliesinvolvedintheprobatesystem;therewasalackoftimelyorclearcommunicationfromsocialwork-erstotheprobatecourt;andtherewasnomonitoringoffamiliesafterguardianshipdecisionsweremade. “We had information, but not the in depth information wehavenow,”saidJudgeFrankJ.ForgioneoftheNorthBranfordProbateCourtandadministrativejudgeoftheNewHavenRe-gionalChildren’sProbateCourt. Researchers,academicsandjudicialexpertsdevelopedaplanforthefirstregionalprobatecourttoaddresstheconcernsraisedbythereport.In2004,theConnecticutGeneralAssemblyautho-rizedthepilotprogramintheNewHavenregion.In2005,legisla-torsauthorizedsixmoreregionalchildren’sprobatecourts. The New Haven court was designed to cover all children’sprobatemattersin10townsandcities.TheregionmirrorstheDepartmentofChildrenandFamilyServicesregion.TheDCFinvestigatesandprovidesinformationforthecourts. Theregionalcourtalsohiredfourmasters’levelsocialwork-erstomonitorandfollowupwithfamilies. Theregionalcourtalsoallowscaseloads tobemoreevenlyamong judges, said Forgione. Before the regional court wasestablished,judgesinthesmalltownssurroundingNewHavenmighthandleadozencasesinayear.Meanwhile,theNewHa-

venprobatejudgewasdealingwith50or60inamonth.Now,allcasesintheregionareevenlydivided. Thereorganizationintoregionsallowsthecourtsystemtobemoreeffectiveinplacingchildrenwithfamilymembers. “Wetaketheteamworkapproach,”saidForgione.“Welookatafamilynetworkandtrytofindsomeoneinthefamilyforanappropriateplacement.” Inonecase, for example, awomanpetitioned thecourt forguardianship of her 16-year-old sister. The sisters shared thesamemotherbutdifferentfathers.Whenthe16-year-old’smoth-erdied,shelivedwithherfatherinNewYork.Thefatherwassubsequentlyinanautoaccidentandwhilehospitalizedwasdi-agnosedwithAlzheimer’sdisease. TheoldersisterwantedguardianshipsoshecouldenrollheryoungersiblinginaConnecticutschool. Thegirlwas16andonlyintheninthgrade.TheprobatecourthelpedtheteenagerwithherplacementneedsandprovidedthesisterswithalistofAlzheimer’ssupportgroupsforteens. Thecourtisalsoworkingwiththefamilytofindcounselingforthegirltodealwiththegrieffromlosingherparentsandthead-justmentsshehashadtoundergoinhernewhomeenvironment.Anevaluationofthe1,855caseshandledduringthecourt’sfirstyearconcluded:

Childrenwere safer,withno reportedcasesof abuseorneglect;

Placements were stable with all children still with theircourt-assignedguardians,eventhoughtwo-thirdsofthosechildrenhadpreviouslybeenthroughmultipleplacements;

Children’s well-being had improved with an increase ingrades,betterbehaviorinschoolandinvolvementincom-munityactivities.

Forgione credits the interbranch cooperation with helpingmakethecourtsasuccess. “We fostered interagency relationships,” he said. “We nur-turedthat.Itwasnosmalldeal.” TofindoutmoreaboutNewHavenRegionalChildren’sPro-bateCourt,visitwww.jud.state.ct.us/probate.

n

n

n

Court Helps Troubled FamiliesBy Jack Penchoff

FastFactsGoalsofNewHavenRegionalChildren’sProbateCourt:

Divert children and families fromwelfaresystem

Improvecasemanagementanddeliv-eryofservices

Empower families to become en-gaged,activecaregivers

n

n

n

�6 statenews november/december�006�6 statenews november/december�006

Affordablehousingforlow-incomeNewJerseyresidentsisinshortsupply.Andforthosewhoaredisabled,thesupplyisevenshorter. HighhousingcostsintheGardenState,verifiedbythemostrecentU.S.CensusfigureswhichshowNewJerseyhasthehigh-esthousingcostsinthenation,intensifytheproblem. Tohelpovercomethosebarriersforstateresidents,officialsdesignedtheNew Jersey Housing Resource Centertomatchanindividual’shousingneedswithavailableunits.Whileoth-erstateshaveonlinehousingclearinghousestohelpresidentsfindaffordablehousing,NewJerseyexpandedtheconcepttogive low-income residents greater choices. The service alsoprovides disabled residents as many as 21 disability relatedsearchcriteria. TheprogramisacooperativeeffortoftheNewJerseyHous-ingandMortgageFinanceAuthority; theNewJerseyDepart-mentofHumanServices,DivisionofDisabilityServices;andtheNewJerseyHousingtheMortgageFinanceAgency.Inad-dition,thoseagenciesreachedouttoUnitedWayofNewJersey.ResidentswithoutcomputeraccesscanuseUnitedWay’sinfor-mationcallcentertoaccesstheResourceCenter. BecauseofexpandedsearchcapabilitiesontheWebsiteandthe collaboration among agencies to get the project online inJune2005, theprogramwas selectedasoneofeightnationalwinnersof2006CSG’sInnovationsAwards. “Findingaffordablehousingistough,”saidSusanBassLevin,commissioner of the New Jersey Department of CommunityAffairs.“TheHousingResourceCentermakesiteasierwiththeclickofabutton.” The resource center depends on technology and interactivefeaturestoprovidelow-incomeanddisabledresidentsthehelptheyneed.

Butit’scustomerserviceandcreativeideasthatmakethepro-gramwork. Landlordsandpropertyowners list their availableunits forfree.Then,consumerscansearchforallunitsinachosencom-munityandnarrowchoicesdowntocategoriessuchas“door-ways thatare32 inchesorwider”andhave“kitchencounterswithaminimumkneeclearanceof27inches.” Homebuyers also have the option of refining searches withmore than 90 criteria, including the Median Family Incomecalculator to help search for housingby income. Eachunit isprofiledontheWebsitewithaphoto,mapandaccessibility. “Weupdate it everyday,” saidLevin. “It onlyworks if it’supdated.” In the first year of the program, potential homebuyers per-formedmore than2million searches.Thirty-threepercentofthe8,000unitsadvertisedontheWebsitefeaturedatleastoneaccessibilityfeature. “Ithinkitisimportantthathavingagenciesonthesamepageisrealandnotacliché,”saidLevin.“It’sdifficultenoughtofindaffordablehousingwithoutgovernmentmakingitharder.” AgrantfromtheU.S.DepartmentofHealthandHumanSer-vices—the Real Choice Systems Change Grant—funded theprograminitsfirstyear.Thisfiscalyear,theprogram’s$227,000annualbudgetisfundedbycontributionsfromthethreecooper-atingagencies. Levin said her department has had positive feedback fromthoselookingforhousing,propertyownersandpublichousingadministrators. “Whenaprojectlikethisworks,”shesaid,“itmakesyoufeelgoodaboutgovernment.” TolearnmoreabouttheNewJerseyHousingResourceCen-ter,visitwww.state.nj.us/dca/hmfa.

New Jersey Housing Resource Center Matches Needs To IndividualsBy Jack Penchoff

FastFacts �millionsearchesperformedinfirstyear

Anaverageof�,�00unitsavailabledaily

8,000 units advertised on the Web sitewererented

33percentof listedunitshadat leaseoneaccessibilityfeature

n

n

n

n


New York Battles Fraud Against Immigrants Immigrantsareeasypreyforscamartists.Newimmigrantsareoftenunfamiliarwiththelaws,cultureandsometimesthelanguage.InNewYorkState, theConsumerProtectionBoardandtheGovernor’sCitizenshiphavejoinedforcestodeliverin-formationtoimmigrantsaboutpotentialfraud. NewYorkhasnearly4millionimmigrants,withmorethan20,000immigrantseachfrom27countries. Inresponsetocomplaintsaboutdishonestimmigrationcon-sultants who make false promises that end up costing immi-grantsthousandsofdollarsandcauseharmtotheirimmigrationstatus,theConsumerProtectionBoardandtheGovernor’sCiti-zenshipUnitdevelopedNew York Immigration Fraud Aware-ness and Prevention,aprogramtoreachimmigrantsthroughcommunitybasedorganizations. TheprogramwasselectedasanalternateintheEastforCSG’s2006InnovationsAwards. The program is designed to help immigrants identify com-monscamsandprovidehelpful tips to immigrantswhen theyaresearchingforinformationandguidance.Thisinformationisprovidedinmorethan18languagesthroughatoll-freehot-linefundedbytheBureauofRefugeeandImmigrationAffairs,anddirectlytoimmigrantsthroughcommunity-basedorganiza-

tions,incollaborationwithcitizenshipservicesprovidersundercontractwithBRIA.Thiscreativeapproachhasproventobeparticularly effective in providing important information di-rectlytothemostvulnerableconsumers. Severalfirmsclaimingtoassistimmigrantswereshutdownasaresultoftheprogram.Inoneinstance,acompanycalledNewVisionwasclosedwhenthestatedetermineditwassell-ingphonyIDstoimmigrantsfromanofficeintheEmpireStateBuilding. In another case working with immigrant organizations, thestatehelped federalofficials investigateaFlorida-basedorga-nization, Haitian American Community Organization. Thatcompanyfiledmorethan10,000applicationsforworkpermitsanddriver’slicenses,manyofwhichwerefraudulent,accordingtoa federal indictmenthandedup thisyear.Theorganizationchargedindividuals$450apieceandnettedmorethan$3mil-lion,accordingtofederalauthorities.Mostofthework-permitapplicationswerefraudulentanddenied. TolearnmoreaboutImmigrationFraudAwarenessandPre-vention,visitwww.nysconsumer.gov.

—Jack Penchoff

alternate



eastern Connecticut’sNewHavenRegionalChildren’sProbateCourt

Delaware’sFosterCareReforminDelaware

MaineBureauofMotorVehiclesEvidenceofInsuranceOnlineSubmittal

NewJersey’sCareerLadders

NewJerseyHelps

NewJerseyHousingResourceCenterHRC

NewYork’sHomePerformancewithENERGYSTAR

NewYork’sImmigrationFraudAwarenessandPrevention

NewYork’sTheLeadershipAcademy

RhodeIsland’sGovernor’sFiscalFitnessProgram

midwestern Illinois’MudtoParks

Iowa’sCRMBillingProject

KansasPharmaceuticalCollaborative

Kansas’ShawneeCountyRe-EntryProgram

MichiganTimelyApplicationandPermitService

Minnesota’s11Milesin1000Days

Ohio’sMultiAgencyRadioCommunicationsSystem

southern Georgia’sCommissionforaNewGeorgia

Kentucky’sJailMentalHealthCrisisNetwork

Kentucky’sPromiseNottoTell

Mississippi’sSupervisionFeeAgentCollectionProgram

NorthCarolina’sGuestWorkerComplianceProgram

NorthCarolina’sSharingOurStories–CulturalConnections

Texas’sMoneyFollowsthePerson

Virginia’sCouncilonVirginia’sFuture

WestVirginia’sMedicaidHealthImprovementDemonstrationProject

western ArizonaHiringGateway

Colorado’sGreeningStateGovernment

Hawaii’sSupportingEmploymentEmpowerment(SEE)Program:SEEHawaiiWork

NewMexico’sTempo(DD/MICollaborativeProject)

Oregon’sHighPerformanceSchoolsProgram

Utah’sUtahClicks/UniversalApplicationSystem

Washington’sSpokenLanguageBrokeredInterpreterServices

Washington’sStatewideIntegratedIntelligenceSystemandtheWashingtonJointAnalyticalCenter(WAJAC)

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

Innovations Awards Finalists by Region

ThepartnershipbetweenCanadaandtheU.S.isoneofthemost dynamic and significant international relationships intheworld. The two countries share a border that stretches more than5,500 miles and are inextricably entangled in issues rangingfromlawenforcementandenvironmentalcooperationtotradeandsecurity.Althoughpoliticaldisagreementsemergeattimes,CanadaandtheU.S.enjoyauniquerapportthathaspersistedthroughoutbothnations’histories. ThemostcommonlydiscussedattributeoftheU.S.-Canadianpartnership is trade—and forgood reason.Bilateral tradebe-tweentheU.S.andCanadaapproachesanamazing$1.4billionaday.Statesandregionshaverecognizedthismassivepotentialformutualeconomicbenefitandhaveledthewayinestablish-ingtradepartnershipswiththeirnorthernneighbors.Canadaisthelargestexportmarketfor39U.S.states. ThetiesthatbindCanadaandtheU.S.gowellbeyondeco-nomicconnections,however. “Canada and the U.S. are absolutely interdependent—eco-nomically,sociallyandenvironmentally,”saidGeorgeCostaris,manager,Political/EconomicRelationsandPubicAffairsoftheDetroitConsulateGeneralofCanada. Increasinginterestinregionalandnationalissuessuchaslabormobility,waterusageregulationsandbordersecuritymeasuresreveals the breadth and complexity of cross-border concerns.Geographicproximityfurtherintensifiesthereciprocalimpactsstemming from theactionsofeachcountry.Therefore, cross-bordercollaborationisanimportantcomponentofprosperityonbothsidesoftheborder. Fortunately,therearemanyexamplesofsuchcooperation.InMichigan,wherebilateral tradeapproaches$70billion,many


Cross-border collaboration with Canada could benefit the United States not only economically, but also in developing sound policies on the environment, health and aging, and security.

By Jennifer Burnett and Meggan Taylor

U.S.-Canadian Collaboration Has Economic, Policy Benefits

Partnership Potential


feltthatcreatinganadditionallandbordercrossingtofacilitatetransportationwasnecessary. “We determined that there was a need for another bordercrossingattheMichigan-Ontarioborder.Thestate,provincialandtwofederalgovernmentsjoinedtogethertocreatewhatisnowknownastheDetroitRiverInternationalCrossingProject,”saidCostaris. Theprimarypurposeofthisgroupistoidentifyalong-termstrategytomeettheneedsofthetransportationnetworkservingthe border between Southeastern Michigan and SouthwesternOntariowhileminimizingadverseenvironmentalimpacts. Anotherillustrationofinternationalcollaborationacrossre-gionaljurisdictionscanbefoundintheNorthwest.The2010Olympics are scheduled to take place in Vancouver, BritishColumbia,andofferanextraordinaryopportunityfortheen-tire region, includingWashington state.Gov.ChristineGre-goirehascreateda task force tooversee thecoordinationofWashington’sOlympicplanningandstrategicinitiativesoverthenextfouryears. CongressmanRickLarson,(D-Wash.)wasappointedco-chairofthistaskforce,whichwillinvestigateopportunitiesandimpacts

infourkeyareas:businessandeconomicdevelopment,tourism,bordersecurityandtransportation.Larsonbelievesworkingco-hesivelywillhelpensurethisendeavorissuccessful. “Wemustworktotakeadvantageoftheeconomicopportuni-tiesthatthese2010OlympicandParalympicsgamesinVancou-ver,BritishColumbia,willbringtotheUnitedStates,”hesaid,“andweneedtoensure thatourfederalagenciesareworkingwith each other, with Canadian officials, and with our state’sofficialsonsecurityintheregion.” Hestressestheimportanceofpolicythatadequatelyaddressesthesafeandefficientflowofgoodsandpeopleacrosstheborder. “TheUnitedStatesneedsapolicythatallowsgoodtraffictoflowintoourcountryacrossthenorthernborderwhilekeep-ingthebadtrafficout,”hesaid.“Wealsoneedtomakesurethatchangesinfederallawdonotcreatelogjamsatourborder.This will become a particular concern as Washington lookstobenefitfromthetremendouseconomicopportunitythatthegameswillbring.” Theseare just twoofmanyexamples inwhichastatehashelpedidentifyandimplementamechanismaimedatimprov-ingthisimportantanddynamicinternationalrelationship.

< 1 billion

1–4.9 billion

5–10 billion> 10 billionindicates that Canada isstate’s #1 export partner

108

43

626

23

89

13

30

15

73

289

369

26

Hawaii

45

72

93

152

55

69

237 112

51 108

43

174

24

63

16

36

13

212

348

151

58

9

44

69

108

103

219

25 141

VT 12

NH 24

MA 134

RI 19

CT 67NJ 153

DE 16

MD 101D.C. 179.2

Total Bilateral Trade in US $

State jobs supported by US-Canadian trade (in thousands)

103

TheU.S.-CanadianTradeRelationship

Source: www.canadianembassy.org

We need to work together to tap into the best and brightest in our countries, identify best practices, share them, and implement them for the betterment of our citizens.

—Dr. Keith Martin, Canadian Parliment Member

“ ”

Representatives from The CouncilofStateGovernments, localuniversi-tiesandotherresearchinstitutionsre-centlydiscussedcross-borderissuesattheAnnualKentuckyCanadianStud-ies Roundtable. The one-day confer-encefocusedon“DefiningaCanadianIdentity in North America and theWorld.”Thisyear’sU.S.–Canadianrelationsforum included a frank and honestdiscussion with the keynote speaker,

Dr. Keith Martin, a member of Canadian Parliament. Martinaddressedthegroupon“OpportunitiesforCanadianandUnitedStatesCooperationatHomeandAbroad.” Martin,amemberofParliamentsince1993whoservesastheofficialoppositioncriticforforeignaffairs,highlightedseveralareasforincreasedU.S.–Canadiancooperation:

Trade Ninety-fivepercentoftheU.S-Canadatraderelationshipisoutstanding,accordingtoMartin.Morethan300,000cross-bordervisitsoccureachdaybetweenthetwocountries. “I see an enormous untapped potential on what we can dotogether.TheU.S.doessomanygoodthingsinsomanyareasthatitwouldbeprudentforthoseinitiativestobesharedmorevocallyaroundtheworld,”hesaid.

Global Warming MartinbelievesCanadaandtheU.S.havethegreatestoppor-tunitytoworktogetherinenvironmentalimprovements.Cana-da,thelargestoilsupplierfortheUnitedStates,isstressingtheimportanceofenergyefficiencyandemissionscontrol.Accord-ingtoMartin,theeasiestandcheapestwaytolimitgreenhousegases and reduce demand on fossil fuels is efficient buildingconstruction. “We can have a huge impact on reducing harmful green-housegasemissionsbydoingabetterjobofconservingwhatweburn.Thetechnologiesalreadyexist,wejustneedtousethem,”hesaid. Incorporating energy efficiency into buildings from thegroundupcanhaveahugeimpactonreducingharmfulgreen-house gases and expensive energy demand, and according toMartin,thereismuchroomforincreasedcooperationbetweenCanadaandtheU.S.

Afghanistan Currently,2,300Canadiantroopsareresponsibleforthemostunstable,violentpartofAfghanistan—Kandahar.MartinsaidevidencehasshownthemainterroristtrainingcampbeforetheSept.11,2001,attackontheUnitedStateswasinAfghanistan. Martinbelieves the threemajorchallenges facingAfghani-stanandthealliedtroopsstationedtherearethepoppycrop,Af-ghansecurityforces,especiallythepolice,andtheinsurgencyfromPakistan. According toMartin,Canada is employing a3Dapproach:Diplomacy, Development and Defense. He believes coalitioncountriesshould:

Increase development assistance, particularly for educa-tion,healthcareandinfrastructure

WorkwithAfghanstobuildaviableeconomybydestroy-ingtheviabilityofthepoppycrop.Martinadvisespurchas-ingthepoppycrop,destroyingit,thenprovidingfundstofarmersforalternatecrops.

Adequately train Afghan security forces, especially thepolice.Thepoliceforcehasbecomeamajordestabilizingelementwithinthecountrybecauseofficesaregrosslyun-derpaid,andmanyhavetakenupbanditryandthuggery.

Deal with the insurgency from Pakistan using the 3Dapproach.

Terrorism AccordingtoMartin,thebiggestthreatfacingNorthAmericaishome-grownterrorists—thosewhoarebornandeducatedintheWest.Martinbelievescountriesmustincreaseinvestmentindomesticintelligenceoperationstodealwiththiskindofterror-ism.HestressedtheimportanceofworkingcloselywithMus-lim leaders and communities to identify individuals who aremarginalizingthemselvesfromtheircommunitiesandtryingtomountterroristactsagainsttheircountryofhabitation. NoneoftheSept.11,2001,hijackerscamefromCanada,butmany lived undetected in the U.S. for years. Martin believesbothcountriesmustlearnfromthe9/11CommissionReporttoimproveintelligenceoperationsagainstterroristcells. TherootofterroristsupportisfoundincountriessuchasSau-diArabiaandotherPersianGulf states, according toMartin.HebelievesCanadianandU.S.supportforbrutalanddespoticregimesmustbeaddressed,orawarwithoutendwillensue.HebelievesthePalestinian/Israeliconflictmustbeaddressedwithatwo-statesolution.

Genocide Prevention “Wecanworktogethertobuildarules-basedmechanismtopreventgenocide,”Martinsaid.“TheU.S.hasdoneanoutstand-ing job inplaces like southernSudan.Wehavea testcase inDarfuratthispointintime.Ifwedonotintervenenowandsup-porttheUNSecurityResolution1706forapeacemakingforcetogointoDarfur,thanRwandaIIwilloccur.”

Other Issues Martinbelieveshealthcare,preventionofsocialillsandthedemographic time bomb are three additional areas where theU.S. and Canada can work together for solutions. The agingpopulationsofbothcountrieswillhaveadramaticeffectonso-cialprogramsandeconomics,andtheissuemustbeaddressedproactively,hesaid. AccordingtoMartin,oneofthebestpreventionprogramsintheworldistheHeadStartProgramfoundinareaslikeYpsi-lanti,Mich. “Weneedtoworktogethertotapintothebestandbrightestinourcountries,identifybestpractices,sharethem,andimple-mentthemforthebettermentofourcitizens.”

—Jennifer Burnett and Meggan Taylor are research analysts with The Council of State Governments.

Visitwww.keithmartin.parl.gc.caformoreinformation.

n

n

n

n

Keith Martin, member of Parliment

3� statenews november/december�006

Making “Cents” of

Child maltreatment is a significant public health problem in communities across the country. But prevention efforts can have a positive impact.

Child maltreatment is a significant and preventable publichealthproblem inourcountry today. Itpermeates societyev-erywhere—touchingcommunitiesofall sizes, schools,placesofemployment,housesofworship,medicalfacilitiesandneigh-borhoods.Childmaltreatmentdevastatesachild’spsychologicalandphysicalwell-being,tearsfamiliesapartandcostssocietybillionsofdollars. Stateleadersoftenarecalledontorespondtochildmaltreat-ment when an especially horrific case makes news headlinesorthecostofservicestoprotectabusedandneglectedchildrenrisesdramatically.Whenthishappens,themediaandthepublicoftenproclaimthattheChildProtectiveServices(CPS)systemis“broken”or“mismanaged”andchildrendeservebetter. Thisattentionoftenresultsinacallforreformsand“fixestothesystem.”While thesecallsforreformarewell-intentionedandsometimesneeded,thatfocusmissestherealopportunitytoholdapublicdiscussiononanevenmoredifficulttask:prevent-ingabuseandneglectfromoccurring.

Prevention

By James M. Hmurovich and Jane Ascroft


TheU.S.DepartmentofHealthandHumanServicesestimatesthatin2004872,000childrenweredeterminedtobevictimsofchildabuseandneglect.More than 62 percent of these chil-dren experienced neglect, the mostcommon form of maltreatment andthe leading cause of maltreatment-relatedfatalities.Approximately17.5percent of maltreatment victims in2004werephysicallyabused;9.7per-centweresexuallyabused;and7per-centwerepsychologicallymaltreated.Inaddition,14.5percentof thechil-dren were victims of other types ofmaltreatment, including abandon-ment,threatsofharmandcongenitaldrugaddiction. Agrimrealityofchildabuseisthattheyoungerthechild,thegreatertheriskofmaltreatment.Veryyoungchil-drenaretwotothreetimesaslikelytobeabusedasolderones. Very young children are also much more likely to be thevictimsoffatalchildabuse.Thefatalvictimizationrateoftheyoungestchildren—thosewhoarelessthan4yearsold—is88timesashighastherateforchildrenages12to17(seeFigure2).Oftheestimated1,490victimsoffatalchildabusein2004,45percentwereyounger than1and81percentwereyoungerthan4. Itisnottheabsenceofacommoncommitmenttoreduceandeliminatechildmaltreatmentfromoccurring;itismoreaques-tionofhowtoaccomplishthatgoal. Childmaltreatment is aproblem that intersectspopulationswithoutregardtosocioeconomics,raceorethnicity.Childmal-treatmentisalsoexceedinglycomplex;thereisnosinglecause.Thoughitisdifficulttounderstandallcases,anumberoffactorsareassociatedwithanelevatedriskofchildabuseandneglect,including:

Thestressandunsafeenvironmentsbroughtaboutbypa-rentalsubstanceabuseandmentalhealthproblems;

Familyhistoryofdomesticviolence;

Socialisolationorlackofsocialsupport;

Lack of parental understanding of children’s needs andchilddevelopment;and

Poverty.

Where therearemultiple risk factors, the likelihoodofabusebecomesevengreater. Protectivefactors—thosecharacteristicsthatprotectagainstmaltreatmentandcontribute togeneralchildandfamilywell-being—arethemostpromisingstrategiesthatsupportpreven-tion.Asupportivefamily,householdrulesandstructure,secureattachmentbetweenparentsandchildren,extendedfamilysup-port,andnurturingparentingskillsaresomeexamplesofpro-tectivefactors.Othersincludeaccesstohealthcareandsocialservices,parentalemployment,supportiverelationshipsoutsidethefamily,andadequatehousing.

n

n

n

n

n

Abuseandneglecthaveenormouscostsforchildrenandtheirfamilies and for society. A growing body of research showsthatabuseandneglectofinfantsandtoddlersinparticularcaninterferewithhealthybraindevelopmentandcausearangeofphysical,mentalandlanguageorlearningproblems.Inessence,neglectorabusethatoccursatayoungageinitiatesadominoef-fectonthedevelopmentofthechildthatcanleadtopoorschoolperformance,anincreasedneedforspecialeducationservices,juveniledelinquencyandadultcriminality,andinsomecases,ariskoflaterabuseorabusivebehaviortowardsothers. ResearchbytheU.S.CentersforDiseaseControlandPreven-tionalsohasshownthatmaltreatedchildrenareatgreaterriskof experiencing later in life adverse health outcomes, includ-ingalcoholandotherdrugabuse,smoking,obesity,depression,sexualpromiscuityandsomechronicillnesses. Childmaltreatmentalsocostsfederal,stateandlocalgovern-mentsbillionsofdollarstopayforchildprotectionandwelfareservices, injury treatment andhospitalizations, developmentalservices and special education, substance abuse and mentalhealth treatment, law enforcement, juvenile secure detentioncostsandincarceration.AccordingtotheUrbanInstitute,feder-al,stateandlocalagenciesspent$23.3billiononchildwelfareservicesalonein2004. Someparentsaresociallyisolated,havefewresourcestohelpthemthroughdifficulttimes,facestresseswithwhichtheycan-

Prevention

not cope, and/or lack important parenting skills. Parents in thesecircumstances are at greater risk of abusing their children. Therearewaystoreducethelikelihoodofabusebyprovidingparentswithsocialsupport,respitechildcareandeducationtheyneedtobegoodparents. States can meet these goals through programs that haveproventoleadtobetterresultsforchildrenandfamilies,suchas:

Provideinstructionandsupport,oftenthroughhomevisits,tofamiliesofnewborns;

Offer parenting instruction and support for parents as theirchildrenmovethroughdifferentdevelopmentalstages;

Instruct both children and adults how to recognize and re-spondtotherisksofchildsexualabuse;

Expandcommunity supports for families toprovideneededhelpandreduceisolation;

Expand public awareness of how individuals, communityagencies, and public institutions can all helpmake childrensaferandfamiliesstronger;and

Offer support programs that bring research-based interven-tionstopreventionthroughfamilysupport.

Thelogicofthispositioniswellunderstoodandaccepted.Howtoaccomplishitinanenvironmentofbudgetrestraint,limitedtaxincreasesandever-increasingbudgetarydemandsistherealchal-lenge.Theanswerisneithersimplenoruniversal.Eachstatemuststartthisprocessbydecidingonacommonvisionforhealthyandsafe child development. Once that position has been establishedthroughaninclusivepublicpolicyprocess,allsubsequentenablingstatutes, administrative codes and agency policies must supportthatposition. Theremustbeacleartimetableforchangemeasuredbyboththegovernor and legislature so progress toward the common visioncan be measured. States must develop leadership and strategiesthatpromoteinter-agencypolicyintegration,improvedinter-agen-cyinformationsharingandservicesthatarenotfocusedonfund-ingsource,butondesiredoutcome. Asthepublicpolicyisdeveloped,thepreventionofchildmal-treatmentmustbemadeapartofeverydecisiononchildwell-be-ing,notapartfromthosedecisions.Afiscalpolicy thatsupportsandpromotesthepublicpolicymustthenbedeveloped.Publicpol-icyisoftendictatedbyafiscalpolicythatfocusesontheamountofmoneytobespentandacceptsthepastpracticesofhowthatmoneyhasbeenspent. Preventioncannotbeunderstoodasaprogramthatfitsnicelyasalineiteminabudget.Itisapublicpolicypositionthatfocusesandintegratespracticesandproceduresinallgovernmentagencies,re-gardlessofthoseagencies’primarypurposeandmission.Inthiscontext, evendepartmentsofwork forcedevelopment, educationandpublicsafetycanjoinwiththestateagencyassignedtotaketheleadinordertosupportandpromotethisimportantpublicpolicy. Using the collective knowledge of government officials, com-munityagenciesandfamiliesthemselves,logical,commonsenseapproachestopreventioncanbedevelopedthatbringaboutashiftinfundingfrom“backend”interventionservicesto“frontend”orpreventiveservices.

—James M. Hmurovich is the president and CEO of Prevent Child Abuse America. He is the former Indiana welfare director and a former deputy commissioner for the Indiana Department of Cor-rection. Jane Ascroft is the director of public policy at Prevent Child Abuse America.

n

n

n

n

n

n

PreventChildAbusechaptershaveahistoryofservingasdependableandvitalprivatepartnerstostatesdevelopingcomprehensivepreventionplans. Oneexample is theCommunityPartnerships forPro-tecting Children (CPPC) program that is transformingIowa’s child protection system by better engaging thefamilies itservesand involvingcommunitymembersandorganizationsinfamilysupportefforts. Forsixyears,PreventChildAbuseIowahasbeenthekeyprivatepartnerinstateagencyeffortstoexpandtheCPPCstatewide.Inadditiontomarketingtheprogramaroundthestate andbuilding connectionsbetween localCPSofficesandcommunitymembers,PCAIowahasadvocatedbeforethegovernor,statelegislatureandadministrativeofficials.Asaresult,legislativesupportfortheCPPChasgrownexpo-nentially,andtheprogramwillsoonbeinall99Iowacoun-ties. “The partnership between PCA Iowa and the stateagency is uncommon in the government world; in fewother ways do the private and public sectors work to-getherthisclosely,”saidSteveScott,executivedirectorofPreventChildAbuse Iowa.“This jointeffort at the statelevelmodelswellwhatthestateagencyencouragesCPPCsitestodevelopandimplementatthecommunitylevel.” AmajorcomponentofthePreventChildAbuseAmericastrategicplan is todeveloppartnershipswith like-mindedand/ormission-relatedagencies.Moreimportantly,itisclearthatthestatesarethereallaboratoriesforchange.Thead-agethatthe“federalgovernmentwon’tletusdothat”ofteniswithoutbasis.Often the stateplan required for federalspendingiscraftedinamannerthatactuallyhindersthede-velopmentofconsistentandeffectiveinter-agencydeliveryofbasichumanservicestofamilies.Andoftenastatelegisla-torwithapassionforrealandeffectivechangecanbethecatalystforareinvigoratedpublicpolicythattrulyprotectsandpromoteshealthyexperiencesforchildren. “State legislatorswill benefitbyworking inpartnershipwithPreventChildAbuseAmerica and its state chapterstoassurethatstatepoliciesareinplacetopreventchildrenfrombeingabusedorneglected,”saidDelawarestateRep.DeborahD.Hudson,chair-electforCSG. PreventChildAbuseAmericaanditsstatechapternet-workcanbeavaluableresourcetostateandlocalofficialswhowanttotakestepstostrengthenfamiliesandreducechildabuse.PreventChildAbuseAmericabelievesthemosteffective and humane solution to the child maltreatmentproblem is to prevent abuse and neglect fromoccurring.Child maltreatment prevention efforts include activities,strategiesorprogramstoreduceriskfactorsandincreaseprotectivefactorsidentifiedintheresearchliteratureasas-sociatedwithchildmaltreatment. Prevent ChildAbuseAmerica broadly defines preven-tionsoitencompassesactivitiesthattargetnotonlyfamiliesidentified as at greater risk of abuse or neglect, but alsoeffortsthathavethepotentialtoimpactallfamilies,andthecommunityandsocietyat large.This isknownasprimaryprevention. ForinformationonPreventChildAbuseAmericaoroneofits43statechapteraffiliates,visitwww.preventchildabuse.org.



State Treasurers Help Gulf Coast Area to Rebound

It’sbeenmorethanayearsincehurricanesKatrinaandRitaripped into the Gulf Coast. The area is recovering, and statetreasurersaredoingtheirparttoassistintheefforts. TreasurersinGulfCoaststateshavebeeninstrumentalinen-suringfundingisavailabletoassistwithimmediateneeds,includ-ingprovidinglocalgovernmentswithaccesstoliquidity,coveringstatedebtserviceandsecuringtaxincentivesonCapitolHill. WithassistancefromStateTreasurerJohnKennedy,forex-ample, Louisiana is issuing tax-exempt private activity bondsandGulfTaxCreditBondspursuant to theGulfOpportunityZoneActof2005.(GOZA) Alabama continues to see positive results from State Trea-surerKayIvey’sdecision torestart thestate’sLinkedDepositProgram.Thisprogram,establishedbythelegislaturein1988,allowsthestatetreasurertoplacestatefundsinAlabamabanksat 2 percent below the market interest rate. The bank agreesthentolendthefundstoAlabamaindividualsorbusinessesat2percentbelowthenormalchargetohelpvictimsofdisasterssecureemergencyshort-termloans. Mississippiwasremovedfromfinancialratingagencies’neg-ative watchlist last December with help from State TreasurerTateReeves.Theagenciesallreaffirmedthestate’slongstand-ingGeneralObligationBondsAAratings.

Louisiana GOZAallocatednearly$8billionintax-exemptprivateac-tivity bonds to Louisiana to finance the cost of qualified pri-vatesectorprojects inhurricane-impactedareas.Projects thatcan be financed with bond proceeds include the acquisition,constructionandrenovationofcommercialproperty,qualifiedlow-incomeresidentialproperty,andpublicutilitypropertyinhurricane-impactedareas. TheLouisianaStateBondCommissionsold$400millioninbonds tohelphurricane-impactedpolitical entities inOrleansParishmakedebtservicepaymentsandavoiddefaults.Thesalewillbeusedby13Orleansareaagencies,whichqualifiedfordebtserviceassistance,fordebtservicerelief. The state pays the principal on the Gulf Tax Credit Bondsbonds, localgovernmententitiespaythestatebackover time,andthefederalgovernmentpaysbondbuyerswithfederal in-come tax credits instead of interest. It was the first time any

statehadsoldsuchalargeprincipalamountofbondscarryingafederaltaxcredit.

Mississippi ImmediatelyafterHurricaneKatrinahitMississippi,Reevessaid“ourgoalistopreparefortheworst,hopeforthebest,andexpectsomewhereinbetween.” Hisinitialplansincludedensuringthestate’sfiscalsolvency,providingloansforlocalgovernments,workingforthepassageofGOZAandmakingregularconferencecallstoreassureWallStreetthatMississippicouldrecover. Today,Mississippi’sfiscaloutlookismuchbrighter.Thepre-viousfiscalyearendedwitha$70millionunallocatedsurplus.Totalstatebondindebtednesshasactuallydeclinedinthelasttwoandahalfyears.Thestate’sfiscalyear’07budgetsetsaside2percentforrainydayfunds. AmajorreasonforthepositiveeconomicnewsinMississippiis theamountofcapitalflowingtotheareaduetoinvestmentopportunities.

Alabama Atmore,Ala.,restaurateursChrisandBethMcElhaneywerethefirstAlabamians to takeadvantageof theLinkedDepositProgramsinceitrestarted.TheyusedtheloantorenovatetheirrestaurantafterHurricanesDennisandIvandamagedthestruc-ture.IveymetwiththeMcElhaneysabouttheprogram. “IhopetheexamplesetbytheMcElhaneyswillshowotherAlabamianswhohavebeenhithardbyrecentdisastersthatthismoneyisavailableandcanbeusedtohelpthemrebuildtheirlives,”Iveysaid. Statetreasurersfromacrossthecountrywillaslodotheirpartto assist with hurricane recovery efforts. On Dec. 6, the Na-tionalAssociationofStateTreasurersissponsoringthe“LendaHandtoNewOrleans”communityserviceproject,followingtheirTreasuryManagementConferenceinNewOrleans. Formoreinformation,visitwww.nast.org.

In August 2005, Louisiana State Treasurer John Kennedy spoke with a displaced family from New Orleans awaiting transportation to the As-trodome in Texas. Photo courtesy: Louisiana State Treasurer’s Office.

By the National Association of State Treasurers

of the GulfTreasures


Inthewakeofoneofthiscountry’sworstnaturaldisasters,theEmergencyManagementAssistanceCompact(EMAC)stillfa-cilitateddeliveryofpeopleandequipmenttoLouisianaandMis-sissippiafterthedevastationofHurricanesKatrinaandRita. That was the primary achievement cited in the just-released2005HurricaneSeasonResponseAfter-ActionReport (AAR).Accordingtothereport,despitedemandsputonthesystembythecatastrophicevents, thecompact and its leadershipworkedeffectively—delivering unprecedented levels of personnel andresourcestotheaffectedareas. TheAARistheculminationofnearly10monthsofintensivereview.Itidentifiesthecompact’smajoraccomplishmentsaswellasareasthatneedimprovement.Thereportnotesthatthe2005civilianEMACresponsewas23timeslargerthanthe2004de-ploymentofresourcesunderEMAC—from800in2004tonearly20,000in2005.Inaddition,EMACdeployedmorethan46,500NationalGuardmembersinthe2005hurricaneresponse. Thereportalsoincludessuggestionsforimprovement,suchas:

Developingamajoreducationalandpublicawarenesscam-paigntoensurethatallrelevantpartiesunderstandEMAC’spurpose,restrictionsandoperationalparameters;

Improving accountability of personnel deployed underEMAC;and

IncreasingfundingtomaintainandgrowEMAC.

FindingsfromtheAARwerebasedonsurveys,facilitatedfo-cusgroupsandinterviewswithstakeholdersandemergencyre-sponderswhoweredeployedduringtheHurricanesKatrinaandRitaresponses.Theserepresentativescamefromawidevarietyofdisciplines,includingsearchandrescue,lawenforcement,medi-calresources,humanresources,publicworksandmanyothers. TheAARisavailableontheEMACWebsiteatwww.emac-web.org.However,becauseofitssize,itcouldtakeapproximately15-20minutestodownload. EMACisadministeredby theNationalEmergencyManage-mentAssociation(NEMA).

n

n

n

EMACIssuesReportonHurricanes

TheCouncilofStateGovernments’EasternRegionalCon-ference held its second annual Robert J. Thompson EasternLeadershipAcademy(ELA)inPhiladelphiaSept.17-21.Theprogram, presented by the University of Pennsylvania’s FelsInstituteofGovernment,helpedtheregion’sbestandbright-est officials develop their leadership skills and examine thesignificantpolicyissues. Lawmakersandstateofficialsfromallbranchesofgov-ernmentfromnineEasternstates,PuertoRicoandtheCa-nadianprovincesofOntarioandQuébecparticipatedintheacademy. By focusing on the most important regional trends facingstategovernmentofficialstoday,scholarsfromtheUniversityofPennsylvaniaandoutsideexpertsprovidedacontextforpar-

StateOfficialsGatherforEasternLeadershipAcademy

Pictured are MNA Tony Tomassi, back row left, Jeff Shaw, Robert Strong, Rep. John Morley III, MPP Dr. Shafiq Qaadri, Marwan Kreidie, Jeff Terbrusch, Wali Abdul-Salaam, Rob Mujica, Sen. Roberto Arango, Sen. Jose Emilio Gonzalez; Rep. Robert Duchesne, middle row left, Rep. Donald Pilon, MPP Bas Balkissoon, Rep. Javier Rivera-Aquino, Rep. Toni Walker, Kerry A. Kelley, Mary Kate McLaughlin, Jennifer Cohan, Matthew Millea, Assemblyman Michael Benedetto; Rep. Chris Barstow, front row left, James Nestor, Sen. Jeanette White, Assemblywoman Ginny Fields, Rep. San-dra Major, Rep. Helene Keeley, Judge Christine McEvoy, Luis Hidalgo, MNA Jona-than Valois.

ticipants to analyze policies and programs,evaluate information and communicate suc-cessfullywithconstituentsandcolleagues. This year’s dynamic program focused onleadership,regionalismandethicsingovern-ment; consensus-building, topics in healthcare and education; and strategies for timemanagementandmediarelations.Participantspraisedtheprogramasthought-provoking, insightful, and a great source ofprofessional andacademic inspiration.Theyalso remarked favorably on the nonpartisannatureoftheacademy. Speakers included Delaware Gov. RuthAnn Minner; Kathleen Hall Jamieson, di-rectoroftheAnnenbergPublicPolicyCen-ter;AlanRosenthal,aprofessoratEagletonInstitute of Politics at Rutgers University;New Jersey Assembly Speaker Joseph J.Roberts Jr.; Delaware House Majority

Leader Wayne A. Smith; Donald F. Kettl, director of FelsInstitute of Government; Honorable William Bablitch, re-tired Wisconsin Supreme Court justice and former Housemajorityleader;U.S.AirForceLt.Col.Dr.DanielJ.MillerJr., leadership trainer; and Feather Houstoun, president oftheWilliamPennFoundation. Theprogram isuniquebecause it brings togetherofficialsfrom the legislative, executive and judicial branchesof stategovernment who rarely cross paths; today’s most importantpolicy problems demand solutions that cut across the usualboundariesofstategovernment. ParticipantswerechosenbymembersoftheCSG/ERCEx-ecutive Committee and ELA alumni based on their leader-shippotential.

csgspotlight

csgspotlight

The Council of State Governments (CSG), in cooperationwiththeU.S.DepartmentofDefenseOfficeofPersonnelandReadiness,convenedanationaladvisorygroupinOctoberandNovembertoexaminethecreationofanewinterstateagree-mentimpactingthechildrenofmilitaryfamilies. Military families move between posts on a regular basis.Whilereassignmentscanoftenbeaboonforcareerpersonnel,theycanpresentchallengesto thechildrenofmilitaryfami-lies.AccordingtotheMilitaryEducationCoalition,theaver-agemilitarystudentchangesschoolsmorethantwiceduringhighschoolandmostmilitarychildrenwillbeinsixtoninedifferent school systems in their lives, from kindergarten to12thgrade. Theadvisorygroupfocusedon the issuessurrounding theinterstatemovementofschool-agedmilitarychildren,theim-pactsuchmovementhaveonacademicperformanceandotheractivitiesaswellaspossiblesolutionstoimproveeducationaloutcomes for these children. The advisory group, composedofrepresentativesfromseveralpublicorganizationsaswellaslocal,stateandfederalpolicymakersandeducationofficials,developed recommendations tobe included in theupcomingEducatingMilitaryChildrenCompact. Thegroupexaminedsuchissuesas:

The transfer of records.Childreninmilitaryfamiliesoftenareplacedinclassesincorrectlybecauseoftimelapsesbe-tweenentryintoschoolandthearrivaloftranscripts.

Course sequencing. Varying prerequisite course require-mentsamongstatescanresultinrepetitivecoursecontentorincorrectplacement.

Graduation requirements.Insomestates,specificcoursesare required for graduation, which may prevent studentsfromgraduatingontime.

n

n

n

Exclusion from extra-curricular activities.Studentswhoen-rollinschoolafterauditions,tryouts,electionsandmember-shiprecruitmentperiodsoftenareeliminatedfromactivitiesthatpromoteconnectiontotheirnewschoolcommunities.

Redundant or Missed Entrance/Exit Testing.Childrenwhomovefrequentlycanbepenalized formissingstateman-dated tests required to enter or exit various levels of theeducationalsystem.Testsareoftenspecifictothestate,soentrance/exitteststakeninotherstatesarenotrecognized.

Kindergarten and First Grade Entrance Age Variances. Children enrolled in kindergarten in one state may notmeetagerequirementswhentheytransfertoanotherstate.Childrenwhohavecompletedkindergarteninanotherstatearesometimesdeniedentryintofirstgradeiftheydonotmeettheagerequirement.

Power of Custodial Parents While Parents are Deployed. Due to circumstances created by military deployment,there are times when children are placed in the care ofdesignatedguardians.Legislationisneededtoprotectthechildrenof thesefamiliesso theymaycontinuetoattendtheirschoolorrelocatetotheneighborhoodschooloftheirnewlyappointedguardian.

Under theproject,aseparatedraftingteamisworkingtodevelopaninterstatecompacttoaddresstheseandotheris-sues impacting school-aged military children. The draftagreement is expected to be completed by the summer of2007 with a national comment period in the fall. The newcompact shouldbeavailable for legislativeconsideration inJanuary2008. For more information, contact John Mountjoy, director ofCSG’sNationalCenterforInterstateCompacts,at(859)[email protected].

n

n

n

n

GroupExaminesEducationalIssuesofMilitaryChildren


CSG-WESTConvenesColoradoRiverForum

Legislators from throughout the West joined in a daylongforumAug.10toreviewthelatestissuessurroundingmanage-mentoftheColoradoRiverBasin.ThesevenstatescomprisingtheColoradoRiverBasinareCalifornia,ArizonaandNevadain the lower basin, and Colorado, Wyoming, Utah and NewMexicointheupperbasin. TheBreckenridge,Colo., forum—chairedbyArizonaRep.Tom O’Halleran—included discussions about planning forshortages,aswellascooperativereservoirmanagement.Law-makersandexpertslookedatcurrentwatersupplyanddemandchallenges and international management issues. In addition,staffprovidedparticipantsanoverviewofcompacts, treaties,legislation, court decrees and federal administrative actionsthat regulate theuseandmanagementof theColoradoRiver,alsoreferredasthe“LawoftheRiver.” SpeakersfromallsevenColoradoRiverBasinstates,aswellaskeyfederalofficials,andawide-rangeofurban,rural,en-vironment,academic,regionalandinternationalstakeholders,

offeredperspectivesonriverbasinmanagement. TheColoradoRiverBasinisthefastestgrowingregioninthenation,andpopulation in the lowerandupperbasins isexpectedtogrowby39and26percentrespectivelyby2025.Conflictsarisebecausetheriverisover-appropriatedby1.8millionto4.0millionacrefeetofwaterduetoincreasedusebyurban,agricultural, industrial,environmental,and tribalwaterconsumers. Longtermsolutionstowatershortagesincludeconservation,weathermodification,desalination,efficientwatermanagementpractices,conjunctivemanagement,storageandagriculturetourbantransfers. Copiesof the forum’spresentations canbeobtainedat theCSG-WEST Annual Meeting Web site at www.state.co.us/gov_dir/leg_dir/lcsstaff/CSG2006/Powerpoint.html.Clickon“ColoradoRiverBasinForum.” Formoreinformation,contactEdgarRuiz,CSG-WESTwa-terpolicystaff,at(916)553-4423.


conferencecalendar

November 2006Nov.4–8 American Public Health Association—134th Annual Meeting

and Exposition—Boston,MA—BostonConventionandExhibitionCenter.Visitwww.apha.orgformoreinformation.

Nov.�0–�3 CSG/Southern Legislative Conference—Fall Conference—Savannah,GA—HyattRegencySavannah.ContactNaiHallmanattheSLCat(404)633-�866orvisitwww.slcatlanta.org.

Nov.�6–�9 CSG/The National Hispanic Caucus of State Legislators—4th National Summit of Hispanic State Legislators—SanJuan,Puer-toRico—CaribeHilton.Toregister,call(�0�)434-8070.Formoreinformation,visitwww.nhcsl.com.

Nov.�9–Dec.�State International Development Organization—Annual Meet-ing—Phoenix,AZ.ContactChrisWhatley at (�0�) 6�[email protected](�0�)6�[email protected].

Nov.�9–Dec.3 CSG/The National Black Caucus of State Legislators—30th Annual Legislative Meeting—Jackson,MS—JacksonMarriottHo-tel.Visitwww.nbcsl.comformoreinformation.

Nov.30–Dec.3CSG—2006 Annual Trends and Leadership Forum—Phoenix,AZ.ContactWandaHinesat(859)�44-8�[email protected].

December 2006Dec.3–6 CSG/National Association of State Treasurers—Treasury Man-

agement Conference and Exposition—NewOrleans,LA—[email protected](859)�44-8�75.

Dec.7–9 CSG/Border Legislative Conference—XIV Border Legislative Conference—Phoenix,AZ.ContactEdgarRuiz,programdirectorat(9�6)553-44�3ext.�0�[email protected](9�6)553-44�[email protected].

January 2007

Jan.�3–�6 CSG/NASTD—Technology Professionals Serving State Gov-ernment—2007 Southern Region Winter Seminar—NewOr-leans,LA—RoyalSonestaHotel.ContactPamelaJohnsonat(859)�44-8�[email protected].

Jan.�6–�8 CSG/NASTD—Technology Professionals Serving State Gov-ernment—2007 Executive Board Meeting— Lexington, KY—Embassy Suites. Contact Pamela Johnson at (859) �44-8�84 [email protected].

Jan.�6–�8 CSG/National Association of State Personnel Executives—2007 Mid-Year Meeting—Arlington,VA—HyattArlington.ContactLeslieScottat(859)�44-8�8�[email protected],orvisitwww.naspe.net.

February 2007Jan.�6–�8 CSG/NASTD—Technology Professionals Serving State Govern-

ment—2007 Executive Board Meeting—Lexington,KY—EmbassySuites.ContactPamelaJohnsonat(859)�44-8�[email protected].

March 2007Feb.��–�6 CSG/National Emergency Managment Association—2007

NEMA Mid-Year Conference—Alexandria, VA—AlexandriaHil-tonMarkCenter.ContactKarenCobuluisat(859)�44-8�[email protected].

June 2007June�0–�3 CSG Spring National Committee and Task Force Meetings—San

Juan, Puerto Rico. Contact Wanda Hines at (859)�44-8�03 [email protected].

July 2007July�4–�8 CSG/Southern Legislative Conference—Williamsburg,VA.Contact

NaiHallmanattheSouthernLegislativeConferenceat(404)633-�866orvisitwww.slcatlanta.orgforadditionalinformation.

July��–�5 CSG/National Association of State Personnel Executives—2007 Annual Meeting—Williamsburg,VA—ContactLisaCollinsat(859)�44-8�[email protected].

August 2007Aug.��–�5 CSG/Eastern Regional Conference—47th Annual Meeting and

Regional Policy Forum—Quebec City, Quebec—Hilton Hotel.ContactPamelaStanleyat(646)383-57��[email protected].

Aug.�5–�7 CSG/Southern Governors’ Association (SGA)—73rd Annual Meeting—Biloxi, MS. Contact Liz Purdy at (�0�) 6�4-5897 [email protected].

Aug.�5–30 CSG/NASTD—Technology Professionals Serving State Govern-ment—30th Annual Conference and Technology Showcase—Min-neapolis, MN—Hyatt Regency. Contact Pamela Johnson at (859)�44-8�[email protected].

September 2007Sept.�6–�9 CSG/CSG-WEST—Annual Meeting—Jackson Lake Lodge, WY.

ContactLolitaUrrutiaat(6�6)553-44�[email protected].

Sept.�6–�9 CSG/National Association of State Treasurers—NAST Annual Conference—Sunriver,OR.

November 2007Nov.��–�4 CSG Annual State Trends and Leadership Forum—OklahomaCity,

OK.ContactWandaHinesat(859)�44-8�[email protected].

March 2008March�0–�4 CSG/National Emergency Management Association—NEMA Mid-

Year Conference—Washington, DC-JW Marriott. Contact KarenCobuluisat(859)�44-8�[email protected].

August 2008Aug.�6–�0 CSG/Southern Legislative Conference—OklahomaCity,OK.Con-

tactNaiHallmanattheSouthernLegislativeConferenceat(404)633-�866orvisitwww.slcatlanta.orgforadditionalinformation.

December 2008Dec.4–7 CSG Annual State Trends and Leadership Forum—Omaha, NE.

ContactWandaHinesat(859)�44-8�[email protected].

This calendar lists meetings as designated by CSG’s AnnualMeetingCommittee.Fordetailsofameeting,callthenumberlisted. “CSG/” denotes affiliate organizations of CSG. Visitwww.csg.orgforupdatesandmoreextensivelistings.

Othermeetingshavevaluetostateofficials.Purchaseameet-ing listingbycalling (800)800-1910orbye-mailingsales@csg.org.Announceyourmeetingstothousandsinthestategov-ernmentmarketthroughanadvertisementoraWeblisting.

timeline

40 Years Ago—November/December 1966Elections Decided More Than Officeholders TheNovember1966electionswereaboutmorethanpickingexecutiveofficers,andjudges.ADecember1966articleinState Government Newshighlightedseveraloftheproposedconstitu-tionalamendmentsandotherpropositions:

Bond issues.Californiavotersauthorized$230millionforcollegeanduniversityconstruction;NewYorkvotersau-thorized$200milliontoacquireanddeveloprecreationallands;andTexasvotersauthorized$200millionforwaterdevelopment.

Annual sessions.NewHampshirevotersapprovedannuallegislativesessions.Utahvotersrejectedaproposalforan-nualsessions.

Governors’ terms.Massachusettsvotersapprovedjointelec-tionof thegovernorand lieutenantgovernor inMassachu-setts, while Louisiana voters made their governor eligibleforsuccessiveterms.WestVirginiavotersrejectedasimilarproposaltoallowthegovernortorunforsuccessiveterms.

Government.Severalstatesadoptedmeasurestostrengthenstatelegislative,executiveandjudicialbranches,andtoaidlocalgovernment.

Taxes. Idaho and Massachusetts voters upheld the salestaxesinitiatedbytheirlegislatures,whileNebraska’svotersturneddownaflat-rateincometaxandrepealedthestatepropertytax.

25 Years Ago—November/December 1981Changes in Motor Fuel Taxes Morestatespassedmotorfueltaxincreasesin1981thaneverbefore, according toa story in theNovember,1981StateGov-ernmentNews.Of40statelegislaturesconsideringhighermotorfuelcharges,22enactedtaxmeasures.Threeotherstatesslatedincreasesinsubsequentyears. Theneedfortheincreasescamebecauseofdecliningfederalrevenue sources for roads andhighways.The tax increasewasjustonewaystatesdealtwithfallinghighwayrevenues.Theyalsoraisedotherstandardhighwayusercharges,suchaslicense,title,registrationandtruckweightfees.

Update Several states considered at least temporary drops in the mo-tor fuel taxes because of soaring gas prices after Hurricane Ka-trina. The Wisconsin Assembly asked Gov. Jim Doyle to let them

n

n

n

n

n

Althoughthefederalgovernmenttendstogetmoreattention,stateofficialsareoftenonthefrontlinesofcutting-edgetrendsandissues.Ontheotherhand,sometimesinthecommunityofstategovernments,themorethingschange,themoretheystaythesame. Inprintsince1958,State News(formerlyState Government News)haschronicledmanyofthechanges…andcontinuities. Here’swhatwereportedon:

debate a temporary rollback of gasoline taxes during a special session, according to a September 2005 Stateline.org story. In West Virginia, the Senate sought a temporary rollback because of the possibility that the wholesale gas tax would in-crease 5 to 8 cents per gallon in 2006. Missouri considered an option of knocking off 10 cents of the state’s gas tax for two weeks. Washington’s legislature had adopted a gas tax hike, and a citizens group worked hard to have that repealed.

10 Years Ago—November/December 1996The Retooling of Welfare Oregonbeganrevampingitswelfaresystemlongbeforethefederal government’s welfare reform system, according to anarticleintheNovember1996State Government News. Evenbeforethefederalreform,Oregonwastheonlystatetorequire100percentparticipationbywelfarerecipientsinworkorworkpreparationprogramsona statewidebasis.The statewas third in the nation—behind Wisconsin and Indiana—inwelfarecaseloadreductionforaone-yearperiod. TheOregonOption,asitwascalled,requiredallwelfareap-plicantstobeginaworksearchduringtheapplicationprocess.Applicantseligibleforwelfarewhodon’tfindajobduringtheapplicationphasethenmoveintotheJOBSemploymentprep-aration program, a federally funded effort dating back to the1980s. Thestatehadfocusedonspeedyemploymentforwelfarere-cipients for several years. Caseloads dropped from 44,000 inMarch1994tolessthan30,000inAugust1996.Beforethenewemphasisonwork,60percentofOregon’swelfarerecipientsre-turnedtothewelfaresystemwithin18monthsandstayed.Aftertheprogramwasadopted,only15percentreturnedtowelfarewithin18monthsandremained.

Update Many states scrambled earlier this year to meet stiff new fed-eral standards for moving poor people from welfare to work, ac-cording to a July Stateline.org story. But three states—Georgia, Arkansas and New Hampshire—had already revamped their Temporary Assistance for Needy Families (TANF) programs to comply with new rules. California, Michigan and Washington were working out details on new laws designed to boost the num-ber of welfare recipients who land and keep jobs. States that hadn’t enrolled at least 50 percent of poor parents in work-preparation programs by Oct. 1 faced heavy fines. The Bush administration held up Georgia’s revamped welfare system as a model for other states to follow. The state achieved work-participation rates by making the work rules clear to wel-fare applicants from the beginning, monitoring their compliance daily and cutting assistance if they failed to attend assigned work programs or counseling sessions, according to the State-line story.


40 statenews november/december�006www.csg.org, keyword “Tolls”

Application Deadline April 16

Sept. 29–Oct. 4, 2007

The Henry Toll Fellowship Program is nationally

recognized among all branches of state government.

The program serves to equip talented state policymakers

with the skills and strategies to meet the challenges ahead.

The Toll Fellowship Program will convene Sept. 29–Oct. 4, 2007 in Lexington, Ky. Applications are available at www.csg.org, keyword “tolls” and must be postmarked by April 16, 2007 to be considered for the 2007 class.

If you have any questions about the program or application process, contact Krista Rinehart at (859) 244-8249 or send an email to [email protected].

“ ”We ourselves feel that what we are doing is just a drop in the ocean. But the ocean

would be less because of that missing drop.

—Mother Teresa

Vol. 49, No. 10 The Council of State Governments November/December 2006 · the council of state...

Documents

Transcript of Vol. 49, No. 10 The Council of State Governments November/December 2006 · the council of state...