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STATE LEGISLATURES MAGAZINE MAY/JUNE 2019 Unlocking Access Free tuition programs are opening doors for some students— but are they making the grade? 6
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STATE LEGISLATURES MAGAZINE May/June 2019 Volume 45 | No. 3 FEATURES DEPARTMENTS Trends | 2 6 | Unlocking Access Complete count committees, Medicaid work requirements, Free tuition programs are opening doors immunizations and more for some students—but are they making the grade? StateStats | 17 Banking on Marijuana 12 | Diagnosis: Alzheimer’s Stateline | 18 States are taking bipartisan action to The brighter side of legislative combat the nation’s costliest disease. news 28 | Jackpot in Jeopardy Legislative Staff Week: Special Section | 21 Federal opinion threatens states’ rights • Welcome, by Jon Heining over online gambling. • My Life Before the Legislature, by Jane Carroll Andrade 30 | Death Penalty on Trial • Toolbox: A Primer on Executions are down, but state attention Peacemaking, by Megan McClure B:11.125" S:10.625" T:10.875" to capital punishment is up. • Why I Love the Legislature, by Adrienne Fischer and Kae Warnock 28 Newsmakers | 34 What’s happening under the domes Yes, No, Maybe So | 36 What does “due process” mean? The Final Word | 37 New York Senate Majority Leader Andrea Stewart-Cousins STAY IN TOUCH 30 Agree with something in the magazine? Disagree? We’d love to hear your thoughts. Drop us a line at magazine@ncsl.org. Executive Director Online Magazine Denver State Legislatures (ISSN 0147-0641) is published 6 times a year by the National Conference William T. Pound Ed Smith 7700 East First Place of State Legislatures. ©2019, All rights reserved. Reproduction in whole or in part without Editor Mark Wolf Denver, Colorado 80230 permission is prohibited. Requests for permission to reprint may be emailed to Julie Lays Julie Lays NCSL President (303) 364-7700 at: julie.lays@ncsl.org. Opinions expressed in this magazine do not necessarily reflect NCSL Senator Toi Hutchinson, Washington, D.C. policy. State Legislatures is indexed in the PAIS Bulletin and Expanded Academic Index. Assistant Editor Kevin Frazzini Illinois 444 N. Capitol St. N.W., Annual subscription rates: U.S.—$49; foreign—$55; teachers—$25 (promo code SLMTEA). NCSL Staff Chair Suite 515 Contributing Editor Washington, D.C. 20001 Single copy: $6.50. Periodically, NCSL rents mailing labels to other organizations. If you Jane Carroll Andrade Jon Heining, prefer your name not be included please send a written request. General Counsel (202) 624-5400 Legislative Council, Postmaster: Send address changes to: State Legislatures magazine, 7700 East First Place, Texas Denver, CO 80230. MAY/JUNE 2019 | STATE LEGISLATURES | 1
Trends 2020 CENSUS With Much on the Line, States Want Complete Counts House Seats in Play In a decennial version of musical chairs, data collected in the 2020 census will be used to allocate the U.S. House of Representative’s 435 seats to the 50 states. Census watchers already are using projections of data released last year to predict which states will gain seats and which will lose them. Biggest projected seat gainers: Texas (+3 seats to 39) and Florida (+2 seats to 29) Other gainers (all +1 seat): Arizona to 10 total; Colorado to 8; Montana to 2; North Carolina to 14; and Ore- gon to 6 Projected seat losers (all -1 seat): Alabama to 6; California to 52; Illinois to 17; Michigan to 13; Minnesota to 7; New York to 26; Ohio to 15; Penn- sylvania to 17; Rhode Island to 1; and West Virginia to 2 Complete count committees—set up many other state and local bodies to Source: POLIDATA to make sure the census counts everyone, which members are elected from districts. just once and in the right place—are more (Indirectly, the census also determines popular than ever. At least 29 states have how many presidential electors a state committee. Alabama expects to allocate a state-level committee in place and more has.) With congressional seats on the line, $480,000, or about 10 cents per person. are in the works. states on the cusp of gaining or losing one Complete count committees can per- “Nearly every state is in the process are particularly motivated to ensure their form an outreach role by using the govern- of forming a statewide complete count residents are counted. ment’s bully pulpit to encourage participa- committee, something that did not occur The federal government will distrib- tion. But they can have a subtler impact as during the 2010 census,” says Tim Olson, ute more than $880 billion annually for well. If funding is available, a committee the Census Bureau’s associate director a decade using funding formulas based can encourage participation through mi- for field operations. “The energy and in- on census population counts. The num- crogrants to local organizations, which, in vestment by all levels of government is ber of people counted in 2020 will affect some communities, may be perceived as remarkable, ensuring everyone is counted states’ share of those funds through 2030. more “trusted messengers” than the gov- during the 2020 census.” That can be well over $1,500 per person ernment itself. An accurate count is important be- annually. Whether it’s encouraged overtly or sub- cause census numbers form the basis for No surprise, then, that states are willing tly, getting everyone counted can pay off. electoral representation in the U.S. House to invest in census outreach. California of Representatives, state legislatures and has $154 million set aside for its count —Wendy Underhill and Christi Zamarripa 2 | STATE LEGISLATURES | MAY/JUNE 2019
CRIMINAL JUSTICE Lawmakers Respond to Native Deaths, Disappearances Recent news reports have drawn will admit, only estimates. No one knows requires the state to employ a missing per- heart-wrenching, overdue attention to how big the problem really is because of sons specialist to maintain a database and cases of missing and murdered Indige- underreporting of disappearances and assist law enforcement and families after a nous women and girls. poor data collection. native person is reported missing. The FBI’s National Crime Information This year, 28 measures in 11 states were North Dakota now mandates investiga- Center database lists more than 5,700 introduced to address those issues. Most tive training for law enforcement. A similar Native American women as missing as of (18 measures) were introduced by native measure was pending in South Dakota. 2016. And the Urban Indian Health Insti- legislators; six were enacted. Broadly, the And a new law requires the Washington tute identified 506 cases of missing and bills addressed: creating task forces/in- State Patrol to provide an estimate by June murdered American Indian and Alaska creasing awareness; training/working with of how many native women are missing in Native women and girls across 71 cities in law enforcement; reporting and data col- the state. The legislation provided a model 2018—280 were murder cases, 128 were lection; and congressional action. for similar measures in other states. missing persons cases and 98 had an un- In Montana, “Hanna’s Act”—named “We have to put this on the front known status. for a 21-year-old found murdered on the burner,” said Washington Representative But those numbers are, as researchers Northern Cheyenne Reservation in 2013— Gina Mosbrucker (R), the bill’s sponsor. HEALTH CARE Preparing for Possible High Court Action on Roe With several state abortion cases having the potential to reach strengthening laws protecting access to abortion. the U.S. Supreme Court, state lawmakers have considered a fair New York now permits abortion after the 24th week when the amount of legislation to fortify their views on the issue. pregnancy is nonviable or the woman’s life or health is in danger. Legislatures have passed 423 abortion restrictions since 2010, New Mexico, Vermont and Virginia have considered similar bills. according to the Guttmacher Institute, a Washington, D.C.-based Illinois and Massachusetts have repealed their pre-Roe bans. Mas- research group that supports abortion rights. sachusetts ended its requirement that abortions after 13 weeks be Most recently, the Alabama House passed a bill criminalizing done in a hospital. Washington now requires private insurance abortion to force the challenge. If it passes the Senate and is en- coverage of abortion in plans that also cover maternity care. And, acted, it will be the strictest abortion law in the country. taking a little different approach, Louisiana made it a crime to co- Arkansas recently joined Louisiana, Mississippi, North Da- erce someone into having an abortion. kota and South Dakota in enacting a law that would ban abor- Other measures lawmakers have considered or passed recently: tions if the high court overturns Roe v. Wade, the 1973 ruling that • Restricting abortions after a fetal heartbeat can be detected, legalized abortions nationwide. The Arkansas law, approved by usually around six weeks into a pregnancy. So-called heartbeat 78% of lawmakers, bans all abortions, except during medical bills have been proposed in a dozen states this year and enacted in emergencies, and does not exempt cases of rape, incest or fetal Georgia, Kentucky, Mississippi and Ohio, though a federal judge abnormalities. temporarily blocked Kentucky’s hours after it was signed. Courts Altogether, as of March 1, 18 states have laws to restrict abortion have struck them down in Iowa and North Dakota. if Roe is overturned, according to Guttmacher. Several of those • Requiring facilities to inform women that a two-dose, drug-in- states, including Arizona, Michigan and Oklahoma, had passed duced abortion potentially can be reversed after the first dose. abortion bans before Roe was decided, some forbidding the pro- • Prohibiting abortions because of fetal disability. cedure unless the mother’s life is at risk. • Requiring a married woman to certify in writing that she has Other states are preparing for a possible reversal on Roe by informed her husband about her plans. MAY/JUNE 2019 | STATE LEGISLATURES | 3
MEDICAID Courts Weigh In on Medicaid Work Rules HEALTH Who’s Calling the Shots on Vaccines? A federal judge recently struck down Arkansas’ and Kentucky’s plans to require Medicaid beneficiaries to work, causing uncertainity for the The measles outbreak continues to seven other states with similar plans spread. From Jan. 1 to May 3, 764 cases MEASLES OUTBREAK currently approved by the Centers for were confirmed in 23 states. That’s the Medicare and Medicaid Services. The judge ruled the requirements would highest annual total since 1994 and since the virus was declared eliminated in the 764 undermine the purpose of Medicaid: U.S. in 2000, according to the Centers for Confirmed cases, as of May 3 Disease Control and Prevention. 23 to provide medical coverage to the needy. Both states have appealed the Increases in cases can occur when in- ruling. fected travelers abroad bring it into the U.S., or when there’s a spread in communi- States with confirmed cases This is just “another obstacle in our 90% path to try to do the best we can in Ar- ties with pockets of unvaccinated people. kansas with the chips the federal gov- Early outbreaks occurred in and around ernment and judiciary gives us,” Ar- New York City, where Mayor Bill de Blasio Portion of unvaccinated people likely kansas Senate President Jim Hendren declared a public health emergency for to get measles if exposed to the virus parts of Brooklyn in April. State and local (R) told The Associated Press. health departments investigate measles Other states remain undeterred by Source: Centers for Disease Control cases and outbreaks when they occur, and and Prevention the ruling. Indiana and New Hamp- that can be costly. In and around Seattle, shire continue to run their programs. for example, schools and public health of- Arizona, Michigan, Ohio, Utah and ficials spent more than a $1 million in the recent was released in March. Research- Wisconsin have received approval. first two months of the year to contain the ers in Denmark studied more than 650,000 And Alabama, Mississippi, Oklahoma, illness, according to the Washington State children born between 1999 and 2010. The South Dakota, Tennessee and Virginia Department of Health. results showed no correlation between the all are awaiting approval, according to measles, mumps and rubella vaccine and Measles is highly contagious—up to 90% the Kaiser Family Foundation. an increased risk of autism. of people exposed to an infected person States are using Section 1115 waiv- In fact, kids given the vaccine were 7% will likely get it if they have not been vacci- ers offered by the Social Security Act nated. The disease spreads through cough- less likely to develop autism than those to design Medicaid expansions that ing and sneezing and starts with a high who did not get it. meet their specific needs. One option fever. Then comes a runny nose, red eyes Lawmakers have considered several is to require “community engage- and, finally, a rash of tiny red spots breaks bills this year to limit exemptions. At press ment” from able-bodied recipients, out over the body. It can lead to pneumo- time, a bill to remove personal belief ex- which may include paid and volun- nia, encephalitis (swelling of the brain) and emptions had been passed by Washington tary work, care-giving, seeking work death. lawmakers and was awaiting the governor’s or attending school or job training. Most of those who get infected have not signature. And in Maine and Oregon, bills “We believe ... states are the lab- been fully vaccinated. (It takes two doses.) to remove personal exemptions were work- oratories of democracy,” CMS chief Some people are suspicious of man- ing their way through the process. If those Seema Verma tweeted after the ruling, datory government-run vaccination three are enacted, it would leave 14 states “and we will vigorously support their programs, contending they infringe on with exemptions for personal or philosoph- innovative, state-driven efforts to de- their right to make medical decisions for ical reasons. Every state allows vaccine ex- velop and test reforms.” themselves and their families. Others emptions for medical reasons, and 47 grant Many believe this issue will end up fear vaccines increase the risk of autism them for religious reasons. Only California, before the U.S. Supreme Court, but no and other problems, though several large Mississippi and West Virginia don’t allow one is sure how soon. studies have shown otherwise. The most religious exemptions. MAY/JUNE 2019 | STATE LEGISLATURES | 5
EDUCATION Unlocking Access Free tuition programs are opening doors for some students— but are they making the grade? BY BENNETT G. BOGGS AND LESLEY KENNEDY was at that moment I decided that, with High and Higher God, nothing is impossible, and I have to Skyrocketing college tuition rates have Sandra Timberlake’s life hadn’t quite break this generational cycle.” made the affordability of higher educa- turned out as she’d imagined. Timberlake, now 55, graduated in tion a priority for states. College tuition With the crumbling of her first mar- 2016 from Tennessee College of Applied increased by nearly 260% from 1980 to riage, the newly single mother of four had Technology with two honor degrees in 2014, while the consumer price index been forced to move to the projects in her accounting and medical coding and just grew by only 120%. The annual aver- hometown of Nashville, Tenn. Then one recently received a bachelor’s degree in age cost of tuition and fees is currently night, while lying in bed listening to mu- organizational leadership from the Lip- sic from a family gathering outside, she scomb University College of Professional $48,510 for private institutions, $37,430 for thought about what she heard one of her Studies. It took her a while, but Tennes- out-of-state residents at four-year public new neighbors tell her 17-year-old preg- see Reconnect, an initiative to help adults colleges, $21,370 for in-state students at nant daughter. “Baby, when you turn 18, return to higher education—along with state schools, and $12,310 at community you can have your own project.” a grant and some smart savings—helped colleges, according to the College Board, “I got up, walked into my children’s her not only earn her degree but also fin- the nonprofit private organization that room and kissed each one,” she says. “It ish with no student debt. administers the SATs and a scholarship 6 | STATE LEGISLATURES | MAY/JUNE 2019
“NEARLY ALL OF THE NEW JOBS CREATED AFTER THE RECESSION REQUIRE SOME SORT OF POSTSECONDARY DEGREE.” Tiffany Jones, director of higher education, Education Trust service. Those numbers are beyond many parents’ reach. Tiffany Jones, director of higher ed- ucation at Education Trust, a national nonprofit that works to close opportunity gaps, says this dilemma has led leaders across the political spectrum to search for Some promise programs cover tuition only; others include living expenses. And several new ways to deal with the high costs. Ideas states require students to live and work in the state for as long as they attended college. include forgiving loans, freezing tuition rates, giving credits for certain high school “THE SUCCESS OF THESE courses or for life and work experiences, and offering free tuition. STUDENTS SPEAKS FOR ITSELF Popular, Though Not ‘Free’ AND ALLOWS THE PROGRAM “Free college” has caught the attention TO CONTINUE GROWING.” of many. Seventeen states and more than 350 localities in 44 states have enacted free Representative Bob Behning, Indiana college policies, and 23 states considered Jones Shirkey or are still debating legislation this year. tle with how to increase access to post- Widely known as promise programs, they secondary education in a fair, financially are popular, diverse and, generally, seek responsible way. to: Critics question the value of spending • Address concerns about spiraling col- munity college in the state beginning in lege costs and student debt. taxpayers’ money this way. They cite data 2021, according to Pew’s Stateline. Whit- • Invest in workforce development from the National Center for Education mer’s goal of increasing the number of res- to support a vital and sustainable eco- Statistics showing that only 35% of stu- idents with college credentials is “pretty nomic climate attractive to new business dents who enroll in community college go much meaningless,” Shirkey said. “What if ventures. on to earn a degree or certificate. Some say all those achievements were in underwa- • Send a straightforward message that these are really entitlement programs and ter basket weaving?” pursuing a postsecondary degree, creden- question whether more college degrees Others point out that many jobs don’t tial or license is affordable, especially to will benefit the economy. need four-year degrees. And some prom- those who might not think such a possibil- “We don’t do a good enough job mea- inent business executives, like Apple ity is within reach. suring value,” Michigan’s Senate Major- CEO Tim Cook, are publicly questioning The simple fact, however, is that nothing ity Leader Mike Shirkey (R) told report- whether college prepares workers with is free—expenses must be paid somehow, ers in response to a plan from Governor the skills businesses need for today’s jobs. by someone—and legislatures must wres- Gretchen Whitmer (D) to offer free com- Free community college doesn’t have to MAY/JUNE 2019 | STATE LEGISLATURES | 7
lead to a four-year degree, of course; it the same time, it’s increasingly hard to uates of Kalamazoo’s public high schools offers opportunities to build the mid- access.” will have their college tuition and fees paid dle-skills workforce through postsecond- And it’s not just low-income students for four years. Attracted by the program, ary credentials, some of which can be feeling the burden, Jones says, noting that new families and businesses moved into earned in two years or less. middle- and upper-income students are the community and development grew. As Earning a degree, however, clearly ben- also having trouble affording college “be- enrollments increased, so did the num- efits the person. Current statistics from cause the prices are so astronomical.” ber of teachers applying to work in the the U.S. Bureau of Labor Statistics show schools. Even the overall school climate that the more education a worker has, the The Kalamazoo Experiment improved. And, with greater community more he or she earns. Although most promise programs are support, new schools were built for the “Nearly all of the new jobs created after statewide efforts, they originated at the first time in nearly 30 years. the recession require some sort of post- local level. One of the first was Kalamazoo By almost all accounts, this early prom- secondary degree or credential, so it’s Promise, created in Kalamazoo, Mich., in ise program benefited the community. increasingly the ticket to participate in our 2005 by anonymous benefactors con- But did the number of Kalamazoo stu- economy,” Jones says. “For students and cerned about declining economic devel- dents going to college increase? Yes. A families, a lot is at stake in terms of their opment in the community. 2017 study by the Upjohn Institute for ability to access higher education. But at The program’s simple premise: Grad- Employment Research showed the chance Earning Credit for Work, Life Experience To promote attending and completing college, lawmakers are granting students credit for previous learning experiences. Since 2016, at least 19 states have expanded and simplified the process, sometimes called a “prior-learning assessment,” of giving college credits to students who can demonstrate the skills and knowledge they’ve gained in corporate or military training programs or through professional certifications. At least 13 states help veterans earn credit for learning acquired in the military. And so far this year, 12 states have considered bills to expand prior- learning programs. The programs have been shown to increase the number of students, especially adult learners, who earn degrees or certificates, according to the American Council on Education. Many states grant students credit for prior learning experiences. At least 13 states allow veterans to earn credit for knowledge gained in the military. The bills have taken various approaches. Illinois lawmakers required the state’s public universities to submit institutions. Indiana allowed students to track student progress and participation. their policies on prior-learning credits use scholarships and grants to pay for the The commission used the reports to to the Board of Higher Education for assessments they must take to earn credit. identify challenges and guide revisions of approval. Bills in Idaho and Washington And, to monitor the effectiveness of its state standards in 2017. addressed the transfer of academic programs, Oregon directed its Higher credits between postsecondary Education Coordinating Commission to —Andrew Smalley 8 | STATE LEGISLATURES | MAY/JUNE 2019
6 Ways to Help National Landscape Twenty-four states have enacted legislation to offer some form of Programs Keep statewide promise program. ME Promises AK VT NH A combination of analyses by Edu- WA MT ND MN WI MI NY MA RI cation Trust, the Institute for Higher Education Policy and the Century ID WY SD IA IL IN OH PA NJ CT Foundation offers six criteria suc- cessful promise programs should OR NV CO NE MO KY WV VA DC DE pursue: HI CA UT NM KS AR TN NC SC MD 1 Target low-income students. Cover tuition and living expenses, even if they have other grants. Stu- AZ OK LA MS AL GA dents can use need-based aid such TX FL as federal Pell Grants for books, transportation, child care and other Program enacted and active expenses. Programs enacted but not yet active AS GU MP PR VI 2 Cover fees and tuition. Fees Program expanded often are hidden costs that form Source: College Promise Campaign, April 2019 real barriers to participation. 3 Provide enough aid to help of students enrolling in a four-year col- n Indiana. For 30-plus years, Indiana students seeking bachelor’s lege within six months of completing high has offered the 21st Century Scholars degrees. Community colleges are school increased by 23%, and in any kind program to students who qualify for free a great place for students to begin, of college by 14%. or reduced-price lunch. Students ap- but they should not be the last stop. ply in seventh or eighth grade for awards State systems might consider easing Promises Vary that cover four years of tuition and some transfer requirements so that com- Unlike Kalamazoo’s, most programs fees at participating two- and four-year munity colleges are the beginning of help high school graduates from low- or institutions, public or private. The pro- the pipeline. middle-income families attend commu- gram offers critical nity college. States and localities, however, 4 Keep eligibility requirements support at nearly tailor their approaches to meet their indi- to a minimum. This lets those every step of the vidual needs and priorities. Some cover who stand to benefit the most— process. While in tuition only; others include textbooks, adult, part-time and working stu- high school, these transportation costs and living expenses dents—participate. Keep the focus students must meet such as food and housing. on need-based, not merit-based, aid. 12 requirements, Program requirements vary as well. Ar- such as maintain- 5 Maintain and release data on kansas, for example, requires recipients to remain in the state for at least three years ing a B average, participation, experiences Behning after completing their studies. Students in visiting a college and results. This information, when New York’s Excelsior Scholarship program campus, taking a career interest inventory shared within and among the states, must live and work in the state for as many and completing the Free Application for can lead to stronger, more effective years as they received the scholarship. Federal Student Aid. programs for all. To receive a Nevada Promise Scholar- Participants must be recent high school 6 Invest in student support sys- tems and completion pro- grams. These help students enter ship, students must meet with a mentor and complete 20 hours of community graduates enrolled full time in college. In 2018, the income cap was $45,510 for a service, but the program covers tuition, family of four. The annual cost to the state and successfully complete their registration and other fees. Here’s a look at is approximately $160 million. programs. three programs in greater depth. “Some are often unaware of the finan- MAY/JUNE 2019 | STATE LEGISLATURES | 9
cial aid opportunities and resources avail- dential or license at recommendations from Governor Kate able to help with applications or to adjust a state community Brown (D) contain cuts for community to college,” says Indiana Representative college. Awards are colleges, including the elimination of Ore- Bob Behning (R). The 21st Century Schol- calculated based gon Promise. ars, however, are “more prepared to enter on several factors n Tennessee. A recent development college and hit the ground running, and and cover two ac- worth noting is Tennessee Reconnect. typically perform better than their peers,” ademic years or Established in 2018, the program focuses he says. He believes “education is a good a maximum of 90 on nontraditional adult students who equalizer, and with more educated indi- Roblan academic credit previously began but did not complete a viduals choosing to remain in the state, hours. The student degree or credential. This is what helped Indiana will have a talent pool to attract must maintain satisfactory progress and Sandra Timberlake, the single mom, go businesses and provide services to our lo- may enroll part time. The total annual cost on and finish her degree. Building on cal communities.” to the state is between $20 million and $25 Tennessee Promise, the Reconnect ini- “The success of these students,” Beh- million, substantially less than Indiana’s. tiative offers an online network to enter ning says, “speaks for itself and allows the With college more affordable, Oregon transcript information and explore op- program to continue growing.” Promise students “fulfilled program re- tions and institutions for obtaining a cre- n Oregon. The Oregon Promise pro- quirements at a high rate, and continued dential or degree. gram took a different path. Established into the second year of college at a high Kenyatta Lovett, executive director of in 2015, it is available to all recent high rate,” says Oregon Senator Arnie Roblan Complete Tennessee, an independent school graduates regardless of family in- (D). The program is too new to know its nonprofit advocacy organization created come. Students must have at least a 2.5 effect on completion rates; nevertheless, to improve college completion rates, says GPA and intend to pursue a degree, cre- it already faces hurdles. Current budget the state has benefited from the support 10 | STATE LEGISLATURES | MAY/JUNE 2019
of two governors— much cheaper than four-year institutions. the state’s free college policy. Middle- or one Democrat, one “That being said, community college stu- upper-income students, however, whose Republican—and dents still really struggle to afford college families make too much to qualify for the lawmakers who because of all the other costs,” says Jones, full Pell Grant may still qualify for the free have passed legis- with the Education Trust. “And some have college policy. lation that has in- estimated that those—housing, books, “States like Missouri found that over spired other states. food, transportation, child care, etc.—add a third of their recipients of that partic- In addition to up to about 80% of the total cost of atten- ular program were from families who Lovett covering tuition, dance.” These additional costs can be met were earning over $100,000 a year,” Jones Lovett says, Ten- by other grants, but often require loans. says. (Missouri’s median family income is nessee’s Promise and Reconnect pro- Further, Education Trust research from around $67,000.) “We’re not opposed to grams raise awareness for families and 2018 found free college programs, in many middle- and upper-income students get- students who may feel like college is out states, ended up offering more aid to up- ting support with the cost of college since of reach. “With the term ‘free’ and with per-middle-class students than to low-in- it’s gotten so out of control. We just want to be thoughtful about how we prioritize the supports that are provided,” he says, come students. “A lot of the design of ex- low-income students and their abilities to “I think it’s given a lot more families and isting free college policies at the state level cover the full cost of attendance.” students that belief, that confidence, that is about helping students pay for tuition at college is for them.” community colleges after all of their other A Bipartisan Issue financial aid has been applied,” Jones The student debt crisis and the increas- ‘The Other Costs’ says. This is because low-income students ing expectation that workers have a post- Most state-level promise programs fo- who qualify for the maximum Pell Grant secondary degree to succeed long term in cus on community colleges, which are do not then qualify for more money from the job market will keep lawmakers focused on ways to make college more affordable. One thing Republicans and Democrats can agree on, Lovett says, is that the cost of higher education today is “outrageous.” JUNE 20-23 “On both sides of the aisle, the fact that PROVIDENCE, R.I. student debt is growing and the fact that so many households now can’t participate OCT. 24-27 in higher education because of cost, links both parties to do something about it,” he COLUMBUS, OHIO says. Whether officials look at it from an MAY 6-10, 2020 economic perspective or a social justice or LAS VEGAS moral view, he says, they’re coming to the same conclusion: Costs are too high and SEPT. 24-27, 2020 MAKING we need solutions that make sense. PORTLAND, ORE. For Sandra Timberlake, Tennessee THE MAPS JANUARY 2021 WASHINGTON, D.C. Reconnect changed the trajectory of her family’s future—inspiring her to help oth- ers do what she did. “The program has THE NCSL SEMINARS REGISTER impacted my personal mission in life to ON REDISTRICTING help underexposed people break genera- When it comes to redistricting, TODAY! tional cycles,” she says. “One thing I always said about going back to school is that I can be that role model for that mom out the learning curve is steep. WWW.NCSL.ORG/ there with four children. She sees me and Let us help you and your team REDISTRICT thinks, If she can make it, so can I.” prepare for this complex, once-a-decade task. Ben Boggs is a program principal in education and Lesley Kennedy is manager of digital communications at NCSL. MAY/JUNE 2019 | STATE LEGISLATURES | 11
HEALTH CARE DIAGNOSIS: ALZHEIMER’S States are taking bipartisan action to combat one of the nation’s costliest diseases. BY SAMANTHA SCOTTI funding in his state’s budget. taking some sort of aggressive action to- “It’s just become a life’s calling,” he says. ward your wife because you’re trying to It wasn’t long ago that Scott Plakon “Before Susie’s diagnosis I didn’t know get her in the car,” he says. “So, I’ve tried to thought of Alzheimer’s as that disease that about myoclonic or grand mal seizures, use the platform I’ve been given as a state causes you to forget things then eventu- the agitation, sundown syndrome, hospi- legislator to bring greater awareness, and ally die. tal stays from injuries from the seizure falls it seems to be working.” But in 2014, the Florida Republican re- or wandering—I once found her in our ceived the devastating news that his wife neighborhood doing one of our neighbor’s Widespread and Increasing of 29 years, Susie, who was then 53 years dishes, and the sheriff was called.” Alzheimer’s disease, the most common old, had been diagnosed with Alzheimer’s. There were so many things, Plakon form of dementia, is a progressive neu- Between then and her death in July 2018, says, that “go along with Alzheimer’s and I rological illness that impairs the thinking Plakon not only learned to recognize the didn’t know anything about it.” and independence of millions of people disease for what it truly is, but also became “I didn’t know about being in the mid- worldwide. It’s usually diagnosed in peo- a champion of the Alzheimer’s aware- dle of a parking lot while she’s extremely ple 65 and older, but it starts earlier with ness movement: speaking at rallies, filing agitated and wondering if people are call- subtle neurological changes occurring legislation and protecting and enhancing ing the police because they think you’re years or even decades before symptoms 12 | STATE LEGISLATURES | MAY/JUNE 2019
THE COSTS $350,174 Lifetime cost of care for a person living with dementia, in 2018 disease and to assist unpaid caregivers. Other areas of overlap among the plans include improving home and communi- ty-based services, public awareness and data collection. Caregivers’ Burden It’s not just those diagnosed who strug- gle with the disease. Most caregivers (66%) live with the person in their care, while one-quarter are members of the “sand- wich generation”—caring for both an ag- ing parent and children younger than 18— according to the nonprofit Alzheimer’s Association. Caregivers of people with dementia are twice as likely to report sub- stantial emotional, physical and financial troubles as those caring for people without dementia. Plakon, who has six children, says he was fortunate to have a large family to help with his wife’s round-the-clock care, which, he says, can be “absolutely brutal.” “I think of an elderly couple, where their kids live out of state and they don’t have fi- appear. An estimated 5.7 million Ameri- nancial resources—that can be a real hell- THE CAREGIVERS cans currently live with Alzheimer’s, and on-earth scenario,” he says. “Alzheimer’s 83% reports anticipate this number will more requires 24-7 care, because sleep patterns than double to 11.6 million by 2040. are disrupted, they wake up in the mid- To prepare for the increase, 49 states dle of the night and may try to wander Portion of care given by family and territories have published a state Alz- members, friends or other unpaid off. It requires a team of people to care for caregivers heimer’s plan. The reports examine the someone with Alzheimer’s.” current effect of Alzheimer’s in each state And the cost of care is sky-high. The 16 million and outline steps that could be taken over the next three to five years to support peo- approximate lifetime cost of caring for a person living with dementia in 2018 was People providing unpaid care for ple with the disease and their families. $350,174, according to the Alzheimer’s As- people with the disease Included in nearly every state plan: sociation. The national cost of Alzheimer’s recommendations for dementia training and other dementias in 2019 is projected Source, all figures: “2018 Alzheimer’s Disease for health care and support workers. Most to reach $290 billion, including $195 bil- Facts and Figures,” Alzheimer’s Association, 2018. state plans also have provisions to im- lion in Medicare and Medicaid payments. prove the care received by those with the If no treatment is discovered to slow, stop MAY/JUNE 2019 | STATE LEGISLATURES | 13
or prevent the disease, estimates suggest that the price tag will grow to $1.1 trillion in 2050. What States Are Doing In response, state lawmakers are con- sidering a variety of policy solutions. Some are broad in approach, such as strength- ening payment and delivery systems for all long-term care or connecting unpaid family caregivers with the resources they need. Other policies are more narrowly targeted to individuals with the disease, and most of the work is bipartisan. “Alzheimer’s doesn’t care what politi- cal party you are,” Plakon says, “if you’re male or female or, increasingly, even what age you are.” He notes a slogan he and Florida Representative Matt Willhite (D), with whom he has partnered on the issue, came up with a few years ago: “When you COURTESY SCOTT PLAKON take red, the color of Republicans, and Florida Representative Scott Plakon began advocating for Alzheimer’s awareness during blue, the color of Democrats, and you mix his wife Susie’s four-year battle with the disease. them together, you get purple, the color of Alzheimer’s awareness.” people will have better access to resources the preparedness of long-term support Early Detection and Diagnosis. A 2018 and care to treat Alzheimer’s across the services for aging adults with dementia. Virginia law directs the department of commonwealth.” Oklahoma directed the state board of health to educate health care providers A 2018 Massachusetts law requires phy- health in 2017 to create rules requiring about the importance of early detection sicians to complete a onetime continu- dementia training. And, with its 2016 Alz- and timely diagnosis of cognitive impair- ing education course on the diagnosis heimer’s Disease and Related Dementia ment, and to increase awareness of the and treatment of patients with cognitive Services Act, Illinois established mini- early warning signs of Alzheimer’s and impairments. It also requires hospitals to mum training requirements for employ- dementia. develop and carry out a plan for recogniz- ees of organizations that advertise or Virginia Sena- tor Rosalyn Dance ing and managing patients with demen- verbally offer to provide Alzheimer’s and (D) hopes the bill tia. The law allows doctors to share an dementia related services. will not only better Alzheimer’s diagnosis and treatment plan Dementia Training for First Respond- inform health care with a family member or legal representa- ers. Dementia training is also needed providers about the tive according to existing federal and state for adult protective services officials, disease, but also privacy laws. first responders and law enforcement. raise awareness Building a Dementia-Trained Work- They frequently interact with people of warning signs force. Recognizing that people with Alz- with Alzheimer’s and other dementias Dance among communi- heimer’s or other dementias have unique and are generally among the first to be ties of color, which health care needs, states are consider- contacted regarding emergencies, abuse are at greater risk of developing Alzhei- ing policies to support care providers or exploitation. In 2014, Connecticut es- mer’s and dementia, she says. and facilities, along with family caregiv- tablished mandatory dementia training “During the 2018 General Assembly ers. Oregon requires all direct care staff for a wide range of personnel, including session, I was honored to work with many employed by a residential care facility emergency medical technicians, probate stakeholders in the Alzheimer’s awareness to complete training in dementia care judges, paid conservators and protec- community to sponsor legislation aimed before caring for residents. New Hamp- tive services employees. The legislation at early detection awareness,” she says. shire established a commission in 2017 requires that the refresher training EMTs “As a result of this legislation, I hope more to evaluate the direct care workforce and take every three years for recertification 14 | STATE LEGISLATURES | MAY/JUNE 2019
WHO’S AFFECTED BY ALZHEIMER’S 5.7 million Americans living with Alzheimer’s 2/3 Portion of patients who are women 2x The rate at which older African Americans will get dementias compared with older whites 1.5x The rate at which older Hispanics will get dementias compared with older whites In Florida, Plakon serves on the state’s Alzheimer’s Disease Advisory Commit- tee. He has worked to fund memory dis- order centers and has sponsored bills to require more regular reporting about the disease to the governor and to educate first responders who may be called to deal with situations such as when his wife was found in a neighbor’s home. Plakon says includes instruction in Alzheimer’s and he’s also constantly trying to increase re- DISEASE DATA dementia symptoms and care. spite care funding. Alzheimer’s and Dementia Task 6th Forces. Various states have created task forces to coordinate statewide efforts to “Here in Florida, we have 560,000 fam- ilies affected by this,” he says. “And, with an aging baby boomer population, I’ve Place Alzheimer’s holds in causes ensure quality care for those living with of death described it as a tsunami about to hit our Alzheimer’s or other dementias. state. We need to stay at the forefront on 1 in 3 Wisconsin’s Task Force on Alzheimer’s and Dementia, formed by Assembly Speaker Robin Vos (R), developed the Wis- this in every different area, from policy to budget, so I’m trying to encourage my col- leagues to get ahead of the tsunami before Portion of those 75 or older who die of Alzheimer’s consin Cares Legislative Package. The Leg- it hits the shore.” islature enacted three of the bills the task 4-8 years force introduced in the 2015-16 session, including funding for caregiver respite, mobile crisis unit training and developing Samantha Scotti is a policy specialist in NCSL’s Health Program. Lesley Kennedy, NCSL’s manager of digital Average lifespan of a person after a diagnosis of Alzheimer’s a pilot program to ensure that people with communications, contributed to this dementia who are experiencing a crisis are article. placed in an appropriate setting. MAY/JUNE 2019 | STATE LEGISLATURES | 15
ALZHEIMER’S IS A GROWING PUBLIC HEALTH CRISIS Over 5 MILLION Americans are living with Alzheimer’s. 16 MILLION more are serving as unpaid caregivers. The Alzheimer’s crisis requires bold action by state governments. HERE’S HOW STATE OFFICIALS CAN HELP: Increase public Increase access awareness, early to home and detection, and community-based diagnosis services Enhance the Build a dementia- quality of care in capable workforce residential setting alzimpact.org/state
StateStats Banking on Cannabis Until the federal government lifts its ban on marijuana, most growers, processors and retailers in the rapidly expanding industry will continue to operate on a cash-only basis. Marijuana is legal, either medically or recreationally, in 34 states and the District of Columbia, but not under federal law. So most banks and credit unions are hesitant to work with cannabis businesses, whether legal and state-licensed or not. Without access to a financial institu- tion, these businesses are targets for robberies. That’s why California is debating legislation to create and license charter banks and credit unions to provide limited financial services to cannabis businesses until the federal government establishes protections for all banks. Sixteen other states have passed legislation this year to help canna- bis and hemp businesses access financial services. Congress is now debating the Secure and Fair Enforce- ment Banking Act of 2019, or SAFE Banking Act, which would protect banks against federal punishment for working with state-approved cannabis businesses. Other federal efforts include the STATES Act, which would allow states to craft their own policies on cannabis even if it isn’t legal nationally. Opponents are against the legal trade of marijuana in gen- eral, believing it’s a threat to public health that outweighs any tax benefits a state might gain from it. At press time, the House Financial Services Committee had advanced the SAFE Banking Act with bipartisan support. MAY/JUNE 2019 | STATE LEGISLATURES | 17
Stateline WASHINGTON Compostable You Burials and cremations could soon be laid to rest. Washington lawmakers have sent a bipartisan bill that would legalize an alternative—human composting—to the governor. The process involves placing the deceased’s body in a reusable vessel for 30 days with a mixture of alfalfa, straw and wood chips. The result is a rich soil, according to the Seattle company that hopes to offer the service. When the process is complete, families can take the soil home for use in the garden or donate it to a conservation site. Composting is cheaper than burial, which averages $8,000, uses one- eighth the energy of cremation and reduces the funeral industry’s resource consumption—30 million board feet of wood, 104,000 tons of steel and 1.6 million tons of concrete annually. For a culture that values productivity, here’s a sure way to a fertile afterlife. 18 | STATE LEGISLATURES | MAY/JUNE 2019
COLORADO law. Violators could face jail time or a fine up to $5,000, or Sweet Justice both. Many Florida counties When life gives you lemons and towns prohibit tethering … pass a law that lets you sell animals in extreme weather lemonade! A Colorado mom situations, but the bill, if and her three sons were run- passed, would be the first ning a lemonade stand last statewide law to address the summer in a public park near problem. During Hurricane their home when the police Irma alone, Florida animal shut them down. They didn’t PLASTIC POLLUTION control officers rescued 49 have the necessary permits, Bans on Single-Use Containers Grow dogs and two cats. “We want they were told. “We were to give dogs a fighting chance,” devastated,” the mom told Maine has enacted the first state ban on single-use said Senator Joe Gruters (R), Colorado Public Radio. “We plastic food and drink containers made from polystyrene who introduced the bill. had no idea lemonade stands foam. The law applies to “covered establishments,” such as were illegal.” They aren’t any restaurants and grocery stores. Hospitals, seafood shippers NEW HAMPSHIRE and certain other businesses are exempt. At press time, more, thanks to a new law similar legislation had passed both chambers in the Mary- Marking 200 Years she and her family fought to pass. The law prohibits local land General Assembly with more than enough votes to With 13 Toasts governments from requiring override a veto should Governor Larry Hogan (R) issue one. New Hampshire has been people 18 and younger to get a Connecticut and Vermont were also considering plastic preparing since 2015 for the permit or license to run small foam bans, and California lawmakers were pressing for the 200th anniversary of its State operations—lemonade or craft first statewide ban on single-use plastic shampoo and con- House in July. Notably, the stands, lawn-mowing busi- ditioner bottles in hotels and lodging businesses. building’s dome has been re- nesses—fewer than 84 days gilded with $2 million in gold a year. New Jersey, Utah and leaf. Inside, workers have pol- Wisconsin have similar laws to ished brass, restored sconces EMPLOYMENT recently became the 26th state protect young entrepreneurs. and refurbished visitors’ to eliminate licenses for braid- Work Licensing ing hair and threading eye- galleries. When New Hamp- NORTH DAKOTA Reforms Roll On brows. It’s welcome news to shirites gathered in 1818 to Collared: Service Lawmakers continue to un- the state’s hair braiders, who place the carved eagle atop the dome, they celebrated Animal Scammers ravel the red tape associated once were required to com- with the “Toast to the Eagle,” with work licensing. Arizona plete 1,800 hours of classes but North Dakota joins some now are free to work without a a recitation of 13 toasts. “So, now automatically grants oc- two dozen states in making it government permission slip. we’re going to recreate that,” cupational licenses to anyone illegal to pass a pet off as a ser- said Clerk of the House Paul C. who moves there with a clean vice animal. Falsely claiming a FLORIDA Smith. “We’re actually work- credential from another state. pet as a service animal to “gain ing in partnership with Hen- admission to a public place” It’s the first state to knock No Tether in niker Brewing Co. for a special or to obtain housing now can down a common barrier for Stormy Weather 200-year-old recipe of a cream doctors, manicurists, home result in a fine of up to $1,000. ale that is going to be used for inspectors and many other Leaving a dog tied up out- The bill’s supporters say their the toast.” Henniker’s founder, workers who face new licens- side during a hurricane or efforts were aimed at protect- Dave Currier, served in both ing requirements, paperwork other dangerous storm would ing disabled people who truly the state House and Senate. and fees when they move to a be a misdemeanor if proposed rely on service animals. different state. North Dakota Florida legislation becomes MAY/JUNE 2019 | STATE LEGISLATURES | 19
NCSL Recognizes Legislative Staff and Their Contributions to Our State Legislatures A MESSAGE FROM STAFF CHAIR JON HEINING legislature does. Behind it all are the infor- Congratulations to all my colleagues Legislative Staff Week mation technology staff, whose primary goal across the country whose sessions have at this time of session is to go unnoticed— completed or are about to wrap up. May 6-10 because if you see them, then something has Some of us are still at it. We hope you enjoy the staff-oriented gone very, very wrong. As you read this, we in Texas will have stories in this special section. Look for Regardless of your role, the work is often about another month to go before we finish, more at ncsl.org, on the NCSL blog hard, sometimes tedious and usually thank- assuming, of course, that we get our work and social media pages and on the less. But, most of all, it’s important. Thank done. Now, as my legislature enters its busi- “Our American States” podcast. you for doing it. est and most dramatic period, the true value During Legislative Staff Week, NCSL spot- of legislative staff be- lights you. We celebrate your contributions, comes apparent. appreciate your hard work and encourage you to get involved in Calendars are simply too long for leg- NCSL. This is your organization. islators to be familiar with every piece of And remember, these NCSL resources are available year-round legislation they are asked to consider, so to all staff: staff stay late into the night working to un- • A network of policy experts and databases full of research— derstand those bills and the issues behind available 24/7. them. • Enriching annual seminars for each of NCSL’s professional When legislators have questions, we pol- staff associations where you can connect with colleagues from Heining icy specialists, auditors, finance experts, around the country. lawyers and program analysts are often the • Engaging webinars filled with innovative ideas and best prac- only ones who can ensure they have the tools needed to represent tices designed specifically for staff. their constituents effectively. • State Legislatures magazine, which showcases legislative staff Clerks and secretaries are crucial, as they ensure that the ap- to a national audience like no other publication out there. propriate processes are followed. The communications staff and We have a lot more in the works for the rest of the year. Get in- librarians are vital in informing the public about the work of the volved and make NCSL work for you! legislature. And, when emotions run high, our sergeants-at-arms ensure that the public doesn’t have too much say about what the Jon Heining is general counsel with the Texas Legislative Council. MAY/JUNE 2019 | STATE LEGISLATURES | 21
My Life Before the Legislature Communications staffers rely on lessons learned in fascinating former jobs. BY JANE CARROLL ANDRADE There’s nothing like a legislative session to keep a communications staffer in the present moment. The days whoosh by as they write, record, interact, strategize, post and photograph. They are quick, responsive Guy Bergstrom Senior communications specialist, and responsible, using skills honed in prior Washington House Democratic Caucus positions. In current job since: 1996 Former job: Newspaper reporter What I did: “I covered politics, mayhem Like a lot of legislative staffers, and political mayhem. It was never bor- communications staff bring a wealth of ing.” One particularly memorable day, he got a call from a small-town police chief experiences to their jobs. We persuaded a telling him there was a shooter on the few of them to pause for a moment to revisit loose. “When I got out of my beater car, he shot at me. Not that I was special. He was their pasts. We found a world traveler, a shooting at everybody.” What I brought to the legislature: First, filmmaker, a public relations pro and a “speed is fundamental.” Writing three sto- bullet-dodging journalist. ries before 10 a.m. was great training. Sec- ond, persuasion and structure, which are the most difficult and interesting parts of Come along as we explore their diverse the job. “What they teach us in journalism experiences and lessons learned as they school—the inverted pyramid—is fine for press releases and radio briefs, but what recall their lives before the legislature. lawmakers are really doing 90 percent of the time is persuasion.” Advice for newbies: In a world where communications is “changing by the week,” he recommends learning how to Jane Carroll Andrade is a program director in NCSL’s tell stories. “It’s still about informing the Communications Division and liaison to the Legislative Information press and public. Using storytelling or and Communications Staff Association. These interviews have been rhetorical tools instead of the inverted pyr- edited for length. To read more about our featured staffers, please amid gives people the same information, visit ncsl.org/magazine. just in a package that’s far easier to digest. And that helps do an important job: mak- ing sure people are informed and know how to get involved in their democracy.” 22 | STATE LEGISLATURES | MAY/JUNE 2019
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