Trends in State Policy News



Nuclear Power on a Small Scale

In the power sector, scale has always been king. The business model that underpinned large-scale power plants made sense. The economics were as fixed as the physics. But there are some who are now calling that prevailing wisdom into question—particularly when it comes to nuclear power.

A variety of companies are developing a new type of nuclear reactor known as small modular reactors, or SMRs. In some ways, these companies are turning the old way of thinking on its head, proposing to build nuclear reactors that are a fraction of the size of traditional ones. In other ways, they’re taking a page out of Henry Ford’s playbook, assuming that centralized production of many small reactors will lead to greater efficiencies and cost-savings than the unwieldy process of constructing large, individual projects on site.

If the current environment is any indication, they may be onto something.

There are four new nuclear reactors under construction in Georgia and South Carolina. However, the future of these projects hangs in the balance as the main contractor, Westinghouse Electric Co., filed for bankruptcy protection in March. Its parent company, Toshiba Corp., reported a $6.3 billion loss due primarily to significant cost-overruns and delays at these projects.

To some, this shows that nuclear power is no longer viable. To others, it indicates that the future of nuclear power will be small—and modular.

Recently, the Nuclear Regulatory Commission accepted an application for the first SMR from NuScale Power. Once approved, NuScale will be able to begin construction of its first power plant, which is expected to be located at the Idaho National Laboratory. The plant would have 12 identical reactors, each of which produce 50 megawatts of electricity. By comparison, many nuclear reactors in the U.S. generate close to 1,000 MW or more.

NuScale says its first plant could be operational by 2026, and it has continued to identify additional sites for future power plants.

But NuScale isn’t alone. Terrestrial Energy says it plans to submit a design by 2019, and a handful of other companies aren’t far behind, with a combination of federal and private funding fueling the development. While each design is innovative and unique, all incorporate “passive safety” features, meaning that the plants can shut down safely without power and without operator action: reactors that are impervious to meltdowns.

Beyond the technological improvements, small modular reactors would require less upfront investment funding and are projected to be more cost-competitive than large reactor projects. Their components are small enough to ship less expensively and assemble more easily. Proponents also note their adaptability: They could be placed in sites that lack the infrastructure to support larger nuclear reactors, and for energy-intensive tasks like powering a water desalinization plant.

Critics, however, question their safety and security. Their size and mobility could lead to a greater number of nuclear sites, they say, straining the limited resources available to protect the country’s nuclear assets.

Since 2010, lawmakers in several states have introduced legislation supporting the development of small modular reactors, and a handful have passed. Most of the bills focus on creating nuclear energy task forces to study the research, financing and tax incentive programs around small reactors.

The Idaho Department of Labor estimates that building the first small reactor will create 1,000 direct construction jobs and support an additional 11,800 local jobs servicing the new workforce. The department estimates the project will generate almost $4 billion in total new industry revenue for Idaho Falls.

For two decades, the U.S. stopped building nuclear power plants, and concerns over the upfront costs linger. As the grid transforms over the coming decades, small modular reactors could offer the solution to keeping the U.S. in a global leadership position when it comes to the largest source of carbon-free electricity.

—Daniel Shea

Cyberbullies Go 'Catfishing'

Catfish are easy to farm and a popular, inexpensive and safe food. But in Oklahoma, and about a dozen other states, catfishing can get you in trouble.

The kind of catfish states like Oklahoma are eyeing are cyberbullies who steal others’ identities and likenesses off the internet. They create entirely fictitious online personas who lure unsuspecting users into online romances or who create those profiles to harass, intimidate or threaten.

Oklahoma law defines this kind of scammer as someone who uses social media to grab a person’s name, voice, signature, photograph or likeness without the person’s consent, to create a false identity, for the purpose of harming, intimidating, threatening or defrauding that person. The law allows victims to seek an automatic injunction and money damages. To address First Amendment concerns, the law specifically excludes online parodies or satire. It also does not apply to law enforcement agencies or officials investigating online crimes.

Many states have criminal impersonation laws that potentially could apply to online impersonation. However, at least 12 other states have laws that criminalize electronic impersonation of another person with the intent to obtain a benefit or to injure or defraud another. Also, at least six states include online impersonation in cyberbullying laws. Internet impersonation bills were introduced this year in at least six states. The Oklahoma law, however, is the first to address creating a fictitious person using another person’s photographs or videos.

—Pam Greenberg


Be wary of someone who:

  • Seems too good to be true, with a profile that perfectly complements your own, or who claims amazing accomplishments.
  • Tells tragic tales, like losing a loved one, to gain your sympathy.
  • Has a sparse online profile, with a small number of friends and few photos with other people.
  • Avoids letting you see his face and refuses to use the camera phone.

Check out people you meet online by:

  • Googling their names and basic information, moving on to public record sites, criminal and sex offender records, other social media accounts.
  • Dragging and dropping their photos into Google to see if similar photos appear in other places online.

Protect yourself by:

  • Saving emails and voicemails and taking screenshots of online profiles and private text messages.

Sources: Social Catfish, an online dating resource; PCWorld magazine; Cyberbullying Research Center; and ABC News


Aging at Home Remains Popular

Millions of Americans, including older adults and people with disabilities or chronic illnesses, require long-term services and supports to complete their daily routines. And a growing number of them are choosing to receive those services in their homes rather than in long-term care institutions like nursing homes.

Home- and community-based care ranges from complex services, like IV therapy, to assistance with bathing and dressing, housework and other daily activities. Long-term care at home is individualized and time-intensive—and often paid for by Medicaid, which currently covers about 50 percent of the country’s long-term care expenses. Medicaid spent a total of $152 billion on long term-care in 2014, with the greatest portion—53.1 percent—going to home- and community-based services.

Nearly 90 percent of adults age 65 and older wanted to stay in their current home and community as they age, according to a 2014 AARP survey, and the data suggest it’s cost effective for them to do so. The median annual cost for nursing facility care was $91,250 in 2015, according to the Kaiser Family Foundation. By comparison, one year of home health aide services was almost $45,800 (at $20 per hour, 44 hours per week) and about $18,000 ($69 per day, five days per week) for adult day care. Generally, home- and community-based services are less expensive than institutional care, but may still represent a major financial burden for individuals and their families.

Several states are testing creative home- and community-based programs that aim to help consumers direct their own care, by drafting their own care plans, selecting their personal care assistants (who may be family members), and choosing how and when services are provided. States have established these innovations through various Medicaid waivers or state plan amendments.

With 10,000 Americans turning 65 every day, improving long-term services and supports will remain a priority for policymakers as they consider options for meeting an aging population’s needs and desires.                                                          

—Samantha Scotti

Better Health for Better Grades

The new federal Every Student Succeeds Act requires needs assessments to evaluate how to boost achievement in low-performing schools. The assessments could help identify health and other underlying issues affecting academic performance, according to a new analysis conducted by the Health Impact Project (a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts).

The assessments examine various data, such as standardized test scores and school performance on state accountability goals, to measure the unmet needs of students and schools. They can also be a vehicle to identify issues related to school climate, family and community involvement, as well as underlying factors like students’ housing stability, health or food security, that can affect academic performance. 

Healthier students are more successful in school. For example, research has demonstrated links between asthma and absenteeism, as well as other health conditions and dropout rates. In turn, better educated citizens have greater employment opportunities and earnings, according to the Virginia Commonwealth University Center on Society and Health. And studies show that better educated people enjoy better health over time and live longer with lower rates of chronic disease.

Disparities in health and education track each other closely, too. According to an analysis of data by the Health Impact Project, students from low-income families and students of color are more likely than their peers to have higher rates of diabetes, asthma, obesity and other chronic conditions. These students also are more likely to attend low-performing schools and less likely to graduate high school. 

The needs assessments under ESSA can also be used to incorporate participation from school leaders, parents and teachers. Reaching out to community members and other stakeholders may help school districts connect to new state and local resources, or better coordinate existing efforts that can target a range of factors related to health and education.

Colorado, for example, requires students’ health to be included in academic accountability and improvement planning. The state supports data-collection efforts used by school districts and community partners to help decide where to allocate grants, how to plan local wellness policies, and what new prevention programs should be created.

Across the nation, schools are stretching resources just to provide essential educational services. State and local partnerships could bring additional resources to the table to address more of the underlying factors that can affect students’ success in school. By incorporating health into education policy, states and communities can better address disparities and improve students’ health as well as their educational achievement. 

 —Kate Blackman

Opioid Offensive Ongoing

Opioid overdoses continue to kill Americans at an alarming rate. Improving access to effective treatment for substance use disorders, including opioid addiction, would help combat this public health crisis. “Ensuring that people with substance use disorders have access to evidence-based care is essential to reducing opioid overdose deaths,” says Cynthia Reilly, director of the substance use prevention and treatment initiative at The Pew Charitable Trusts.

The Trump administration announced in April that it will award a total of $485 million in grants to all 50 states, the District of Columbia and the territories to help improve access to treatments.“Opioids were responsible for over 33,000 deaths in 2015; this alarming statistic is unacceptable to me,” Tom Price, secretary of the Department of Health and Human Services, said when he announced the grants. “We cannot continue to lose our nation’s citizens to addiction.”

Price said his department is committed to supporting the most clinically sound, effective and efficient prevention, treatment and recovery services. The department identified four areas for improvement: public health surveillance, pain management, access to treatment and recovery services, and the availability and distribution of overdose-reversing drugs. It will also support cutting-edge research.

Certain insurance policies and practices create barriers for people needing treatment as well as for the providers offering care. When insurance policies don’t cover the costs of treatment, for example, patients often choose not to seek the medications and services they need to get well. The new federal grants will help states in their efforts to make the full spectrum of treatment and services more widely available.

The most effective substance-use treatments can involve a range of interventions, including talk therapy and cognitive and dialectical behavioral therapies, combined with drugs approved by the Food and Drug Administration. Finding the right combination of therapies is patient-specific and can be more difficult if some drugs and services are unavailable.

Even Medicaid doesn’t cover all the services recommended by the American Society of Addiction Medicine in 37 states. Private insurance companies may not cover the most effective treatments either, but, when confronted with a parity violation, they often will change. Federal and state parity laws require most insurance plans to provide coverage for mental health conditions that’s equal to coverage for physical illnesses. The federal requirements are part of both the Mental Health Parity and Addiction Equity Act of 2008 and the Affordable Care Act.

States and territories were awarded the new federal funds based on their rates of overdose deaths and unmet need for opioid addiction treatment. The grants range from a minimum of $2 million in several states to $44,749,771 in California. 

—Karmen Hanson

Additional Resources

NCSL Resources