911 EMERGENCY SERVICES
To Modernize Call System, States Increase Charges
The 911 emergency system receives more than 240 million calls a year, according to the National 911 Program, with about 80% coming from wireless devices. Americans have come to rely on the system and value it as an essential service.
Nearly 70% of respondents to a National Highway Traffic Safety Administration survey were willing to pay more for expanded 911 services if it would shorten the time it takes for emergency responders to locate them during a crisis.
So far this year, South Dakota enacted a bill that allows emergency call centers (aka public safety answering points) to request, on behalf of law enforcement, that a wireless communications carrier provide the location of a telecommunications device, if the information could help in providing emergency services.
In a significant trend last year, state lawmakers modified funding models for 911 services and increased 911 fees and surcharges. Seven states—Arkansas, California, Kansas, Maryland, New York, Oregon and Utah—created new fees or increased 911 service charges for subscribers of telecommunications services and for consumers who make prepaid purchases of cellphone and other services.
NG911 on the Way
Some of the new statutes also make money available to implement Next Generation 911 technology, which expands emergency services considerably. NG911 is an internet-based system that allows users to send photos, text messages and videos to an emergency call center and can reroute the data in case the nearest center has problems or is overloaded with calls.
Text-to-911 services are vital when the caller has a hearing or speech disability, when placing a call could put someone in danger or when call systems are overloaded during disasters
No state has fully deployed NG911, but several are modernizing their systems. Arkansas, California, Florida, Kentucky, North Carolina, Pennsylvania and South Carolina have passed legislation supporting enhanced services, with the laws in California, Florida and North Carolina requiring statewide use of text-to-911.
New and enhanced 911 services require not only technical upgrades, but also changes in the roles and responsibilities of 911 dispatchers. More than 90% of respondents to the traffic safety administration’s 911 survey said they expected to receive instructions such as how to perform CPR or deliver a baby from 911 dispatchers while waiting for an ambulance.
Pandemic Price Gougers Beware
A bottle of hand sanitizer selling for $60, a thermometer for $26, 36 rolls of toilet paper for $80. Reports like these quickly turned public attention to price gouging during the coronavirus outbreak. And states took action immediately.
With grocery stores struggling to keep up with demand for cleaning supplies and other necessities, policymakers moved to protect consumers from outrageous price increases.
Thirty-six states, Guam, Puerto Rico, the U.S. Virgin Islands and the District of Columbia have statutes or regulations that define price gouging during a disaster or emergency. In most states, price gouging is a violation of unfair or deceptive trade practices law. Many of the laws assess civil penalties, though in some states price gouging is a criminal offense.
Eleven states, Guam and the District of Columbia introduced measures addressing price gouging in their 2020 sessions. Maryland, West Virginia, Guam and the District of Columbia enacted legislation.
Maryland prohibited retailers from raising prices in ways that increase the seller’s profit by more than 10% while the governor’s COVID-19 emergency declaration is in effect. Guam made price gouging illegal during an emergency or epidemic or during a disaster.
And West Virginia lawmakers passed a measure amending the definition of “state of emergency” and authorizing the governor to review the scope of price changes during a crisis and the time period during which prices may not be changed. The governor signed the bill March 25; the law goes into effect June 1.
Virus Causing Anxiety for Already Troubled Retirement Systems
In addition to its staggering toll on human life and health, the coronavirus has multiplied financial anxieties for millions of Americans. States with chronically underfunded public employee pension plans are also wringing their hands as investment portfolios suffer serious losses and falling revenue projections stress state budgets.
U.S. public pension plans could be staring down an average investment loss of about 21% for the fiscal year ending June 30, according to Moody’s Investors Service estimates. Huge losses due to COVID-19 threaten to heap additional debt atop a mountain of unfunded pension liability in some states. That is, absent a rapid market rebound, increased government contributions or decreased benefits for retirees.
But, as some observers point out, COVID-19’s full impact on state retirement systems is difficult to predict, and pension funds have two things on their side: diversified holdings and time to ride out market turmoil. California Public Employees’ Retirement System CEO Marcie Frost noted in a recent webinar that pensions anticipate market corrections and that traditional defined benefit structures serve as part of the social safety net, helping ensure financial security for millions of retired workers.
Public pensions’ investment time horizons span decades. Fund managers invest their assets in diversified portfolios that include public equities, bonds and alternatives (real estate, private equity, hedge funds, infrastructure). Some funds maintain lower-risk investment profiles than others. But funds with weaker liquidity (cash on hand or short-term investments used to pay out benefits and administrative costs) may need to sell off assets now at a loss, damaging their funded status, according to S&P.
Because of the way pension accounting works, annual losses or gains are smoothed out over several years so that state and local governments don’t see big spikes in their annual pension bills. As a result, these dismal numbers won’t begin to hit government balance sheets until next year or even 2022. But as states look for longer term budget relief, we are likely to see renewed calls for plan design and benefit changes, like those that followed the Great Recession.
Helping Lawmakers Cut Through the Data Clutter
After an unprecedented spike in suicide rates in Minnesota, the state health department asked lawmakers in 2019 to fund a comprehensive suicide prevention program with telephone crisis lines and grants and training for local initiatives. Agency officials backed up their spending request with evidence showing that crisis lines had improved mental health and reduced rates of suicide elsewhere.
To build their case, the officials turned to the Results First Clearinghouse Database, a research tool created by The Pew Charitable Trusts. The database showed that rigorous research supported the effectiveness of crisis lines, earning them the clearinghouse’s second-highest evidence rating.
Legislators and legislative staff often turn to clearinghouses, or directories, to understand the research behind programs and policies. That can be time consuming given that there are some 20 publicly accessible clearinghouses, according to the Corporation for National and Community Service. The Results First database cuts the time significantly by synthesizing research from nine national clearinghouses.
Results First assigns each policy program in its database a color based on the ratings it received from the nine clearinghouses. Researchers quickly can see if a program is broadly viewed as effective, ineffective or, in some cases, detrimental.
The database currently has information on more than 3,000 programs across various policy areas, including employment and job training, crime and delinquency, child and family well-being, and mental and public health. With information evaluated and gathered in one place, policymakers and agency staff can systematically review programs based on the strength and quality of the evidence behind them.
If the goal is to reduce alcohol use among teens, for example, the Results First database gives the highest evidence ratings to certain programs that educate parents, reinforce young people’s positive qualities in school classrooms and get the community involved to address underage drinking.
Back in Minnesota, lawmakers authorized the funds the state health department requested for suicide prevention programs. It’s too early to know if the evidence directed them correctly, but officials are hopeful.
A Lawmaker’s Guide to Improving Outcomes for Kids
The Family First Prevention Services Act of 2018 offers states an unprecedented opportunity to transform their child welfare systems. Among other things, the law reimburses states for substance abuse and mental health services and for parent skills training to prevent children’s entry into care. The law also seeks to reduce states’ reliance on group and residential treatment settings. Like many federal laws, Family First is big and complicated. Last year alone, lawmakers enacted 47 Family First–related bills in 24 states.
Here’s a how-to guide to the strategies lawmakers are using now to take advantage of the law.
How to Maximize Collaboration
As of mid-April, 11 jurisdictions had submitted their required five-year Family First plans for approval by the federal Title IV-E Prevention Services Clearinghouse. Four of the plans—from the District of Columbia, Utah, Arkansas and Maryland—had been approved, with others expected to be OK’d in coming months.
Some of the plans place the goals of Family First within a broader strategy to improve child and family well-being. Washington, D.C.’s Child and Family Services Agency, for example, embedded its plan in the mayor’s new Families First DC Initiative, an effort to strengthen families throughout the city.
Kentucky is using Family First as a tool to transform child welfare in the state. Its plan involves the Department of Community Based Services, the governor, the legislature, child welfare advocates, private and community agency partners and other stakeholders. According to the overview, the goal is “reorienting around prevention and family preservation and utilizing foster care as an intervention of last resort.”
How to Engage Stakeholders
Lawmakers can work with child welfare agencies and other stakeholders to ensure that community resources, multiple public agencies and individuals who have direct experience with the system are engaged. They can educate legislative peers by leading interim work sessions, calling for informational briefings and forming task forces and work groups. They can request reports identifying eligible prevention programs; assess their agencies’ plans to evaluate programs that have yet to receive federal approval; and request assessments of residential service providers and the costs associated with making them conform with Family First. Lawmakers can also request estimates of the costs that prevention services would avoid. And, of course, they can craft legislation to align state statutes with Family First and appropriate matching funds for prevention services.
A 2019 Michigan law requires the state’s child welfare agency to report to the legislature on the status of the department’s planned and achieved implementation of Family First. Other states mandated analyses and cost projections. Colorado, for example, passed legislation in 2018 that required each county to perform an analysis of in-home, family-like and out-of-home placements and to develop a plan to expand capacity in out-of-home placement.
How to Build Evidence-Based Programs
To help prevent unnecessary foster care placements, Family First allows the use of Title IV-E funds for mental health and substance abuse prevention and treatment services and for in-home parenting skills programs for parents, kinship caregivers and children at risk of placement. The programs must be trauma-informed and meet “promising,” “supported” or “well-supported” levels of evidence as defined by Family First.
As part of their planning process, states are surveying their evidence-based prevention and kinship navigator programs, which are designed to help relatives find services, and identifying gaps in coverage. The Kentucky Department for Community Based Services, for example, partnered with Kentucky Youth Advocates for nine regional forums to engage with stakeholders and integrate their perspectives into program planning. Before the forums began, the department prepared by analyzing data, assessing the risks of child welfare involvement, and evaluating prevention services and placements. The District of Columbia’s Child and Family Services Agency took a similar approach, reviewing data, running client and provider focus groups and identifying candidates for foster care.
How to Limit Use of Group Care
Family First limits federal reimbursements to certain types of group care, including qualified residential treatment programs. Most states are delaying implementation of Family First for up to two years to better prepare to meet the QRTP requirements, which include licensing by a national accrediting body; use of a trauma-informed treatment model; registered or licensed nursing staff on site and available 24/7; family involvement in the treatment process; and six months of support after discharge. Other requirements include an age-appropriate and evidence-based review within 30 days of a child’s placement in a QRTP to determine whether it’s a good fit. A court must rule on the placement within 60 days and continue to find at each status review that the placement is beneficial to the youth.
Some legislatures are amending their statutes to align with these requirements and ensure that children are placed in group care only when clinically necessary. Maine lawmakers, for example, introduced a bill this year that would require a court to conduct status hearings for all children placed in a QRTP within 60 days of a child entering the program. Maryland enacted legislation in 2019 that would, among other things, require a court to review children’s placement assessments.
How to Support Caregivers
Kinship navigator programs help family caregivers identify and access programs and services that will better enable them to care for children. Family First allows states to claim 50% federal reimbursement through Title IV-E for administrative and training costs related to such programs, which must meet the Title IV-E clearinghouse’s criteria of promising, supported or well-supported. As of March 1, no kinship navigator program had been certified as evidence-based.
Some states addressed these programs in legislation last year. A Minnesota law directed the commissioner of human services to review kinship navigator models for relative foster parents and children. And Washington state required its Children, Youth and Families and Social and Health Services departments to evaluate kinship navigator services that would qualify as well-supported, supported or promising, as defined by Family First.
How to Use Transition Funding
States face common challenges as they implement Family First, particularly in meeting the new requirements for evidence-based services, getting federal approval and reducing use of group care. In response, Congress passed the Family First Transition Act of 2020, providing states $500 million in one-time, flexible funding to help with these obstacles.
Due to COVID-19, states are no longer required to have submitted an application by April 30, the original deadline. The federal government will distribute the funds to eligible states, territories and tribes as soon as possible.
The transition act delays by two years the requirement that half of a state’s prevention services claims go toward programs deemed well-supported by the clearinghouse. The level of evidence required for reimbursement will instead be phased in over four years. Congress also increased the clearinghouse’s funding to improve the capacity of the program and speed up evaluations.
Nina is a senior fellow on NCSL’s Child Welfare Project. Contact her for answers to your Family First questions.