Report

DELEGATION MEMBERS AND STAFF

From August 1-4, 2013, two Vice-Chairs of the Canadian Section of the Canada-United States Inter-Parliamentary Group (IPG) – Senator Michael L. MacDonald and Senator Wilfred P. Moore, Q.C. – led a delegation from the Canadian Section to the 2013 annual meeting of the National Governors Association (NGA). The meeting, which was held in Milwaukee, Wisconsin, was also attended by the Honourable Mike Lake, P.C., M.P., Mr. Bob Dechert, M.P. and Mr. Jean Rousseau, M.P.  The delegation was accompanied by Ms. Angela Crandall, the Canadian Section’s Executive Secretary, and Ms. June Dewetering, Senior Advisor to the Canadian Section.

THE EVENT

Founded more than a century ago when President Theodore Roosevelt gathered state governors in order to discuss the nation’s resources, the NGA is the collective voice of U.S. governors from the 50 states, three territories and two commonwealths. It is also a public policy organization that represents the governors on Capitol Hill and before the U.S. Administration on federal issues that affect them, and that develops and implements solutions to public policy challenges.

The NGA, which meets in the winter and summer each year, is supervised by a chair, vice chair and nine-person executive committee, and governors participate on four issue-related standing committees – Economic Development and Commerce; Education and Workforce; Health and Homeland Security; and Natural Resources – and, on occasion, on special ad hoc bipartisan committees and task forces. At the 2013 annual meeting, each of the four standing committees held a session.

The theme for the NGA’s activities in 2013 – including the winter and summer meetings – was “A Better Bottom Line: Employing People with Disabilities.” This initiative was selected by NGA Chair Delaware Governor Jack Markell. The incoming NGA Chair, Oklahoma Governor Mary Fallin, has selected “America Works: Education and Training for Tomorrow’s Jobs” as her initiative for the NGA in 2014.

DELEGATION OBJECTIVES FOR THE EVENT

Members of the Canadian Section of the IPG have been attending the winter and summer meetings of the NGA for several years. At this annual meeting, Canadian delegates were able to continue their dialogue with governors on issues of Canadian and/or joint interest. In particular, they spoke with Governors Neil Abercrombie (Hawaii), Terry Branstad (Iowa), Lincoln Chafee (Rhode Island), Dennis Daugaard (South Dakota), Mark Dayton (Minnesota), Mary Fallin (Oklahoma), John Hickenlooper (Colorado), Dannel Malloy (Connecticut), Jack Markell (Delaware), Martin O’Malley (Maryland), Peter Shumlin (Vermont), Earl Ray Tomblin (West Virginia) and Scott Walker (Wisconsin). As well, they spoke with a range of business leaders and others from across the United States.

Their interactions with governors and others enable Canadian members of the IPG to achieve better the aims of finding points of convergence in respective national policies, initiating dialogue on points of divergence, encouraging exchanges of information and promoting better understanding on shared issues of concern. Moreover, the NGA meetings provide the Canadian Section of the IPG with an important means by which to provide input to, and gather information about, state-level issues that affect Canada. It is anticipated that the Canadian Section’s attendance at the winter and summer meetings will continue.

ACTIVITIES DURING THE EVENT

The 2013 annual meeting of the NGA included the following sessions:

·         State Tools for Health Care Cost Containment (Opening Session)

·         Spurring Workforce Innovation to Close the Skills Gap, Create Jobs and Grow Family Incomes (Education and Workforce Committee)

·         Providing for Our Veterans (Health and Homeland Security Committee)

·         Meeting 21^st Century Homeland Security Challenges (Health and Homeland Security Committee)

·         Under Construction: Building a National Consensus on Infrastructure (Economic Development and Commerce Committee, and Natural Resources Committee)

·         2020 Game Plan: What Tomorrow’s Winners Need to Be Doing Today (Luncheon)

·         Advancing Corrections Reform (Special Session)

·         States’ Role in Cybersecurity (Closing Session).

This report summarizes the key points that were made at the plenary, as well as at selected standing committee, sessions.

STATE TOOLS FOR HEALTH CARE COST CONTAINMENT

Jeffrey Brenner, Camden Coalition of Healthcare Providers

·         Moneys spent on Medicaid are not being well-spent, and 25% of senior Medicaid patients are readmitted to hospital within 30 days.

·         The United States must figure out how to deliver better health care at a lower cost; the country spends twice as much as any other country on its health care system.

·         The United States’ health care system is too complicated.

·         The United States’ health care system does not need more doctors; rather, it needs more committed nurses and social workers.

·         The United States should reinvest in health care outside the hospital setting, and should bring care to people rather than people to care.

·         For the future, consideration should be given to:

§  regulating health care providers;

§  using the leadership provided by the governor’s office to reframe health issues;

§  “keeping it simple”;

§  rethinking the telephone case management model;

§  “freeing the data” and using data differently;

§  building a pathway to support and test health care innovations; and

§   “pushing down” accountability to the level of the community.

SPURRING WORKFORCE INNOVATION TO CLOSE THE SKILLS GAP, CREATE JOBS AND GROW FAMILY INCOMES

Joseph Carbone, The WorkPlace

·         The United States is emerging from the worst recession since the Great Depression.

·         The legacy of the recent recession is a class of people who are “unemployable”; their state is not anything of their doing but, instead, they are “victims.”

·         The “unemployable”:

§  come from every discipline;

§  are often aged 50 or older;

§  become weary of job search and may give up looking for employment;

§  have skills that become obsolete over time as they are not used;

§  deplete their accumulated assets;

§  suffer from depression and diminished self-confidence; and

§  have a relatively low chance of getting back into the labour market.

·         The U.S. Department of Labor should look at the group of “unemployables” as a specialized group that needs particular tools and assistance to re-enter the workforce.

·         The official unemployment rate does not reflect discouraged workers, employees who are underemployed, or those who are working part-time but would prefer to work full-time.

·         In times of high unemployment, employers may expect more from employees and may want to pay relatively less.

·         One option for breaking the cycle of unemployment is the Platform to Employment program, which involves coaching and a wage subsidy for employers.

Teresa Wahlert, Iowa Workforce Development

·         Iowa is a microcosm of the nation, and the counties in the state vary greatly in terms of their unemployment rate; some counties have labour shortages in some regions coincident with long-term unemployed individuals who lack needed skills.

·         In Iowa, 12% of jobs are low-skilled, while 38% of the state’s population is low-skilled; regarding middle skills, the comparable rates are 56% of jobs and 33% of the state’s population.

·         Efforts must be made to match skilled people with the businesses that need those skills, and to help people develop needed skills.

·         The focus should be on helping people find a career, rather than a job.

·         An important question is: what are the critical thinking skills that are required for today and tomorrow?

·         At a minimum, the basic skill sets that are needed include:

§  applied mathematics;

§  reading for information; and

§  searching for information. 

UNDER CONSTRUCTION: BUILDING A NATIONAL CONSENSUS ON INFRASTRUCTURE

Honorable Anthony Foxx, Secretary of the U.S. Department of Transportation

·         Transportation is a “bridge to opportunity” for individuals, families and businesses; it is important to the United States’ economy and the way of life of residents.

·         Transportation “moves America forward” and gives the tools with which to be competitive.

·         Political parties must work across party lines on transportation issues in the same way that federal, state and local governments must work across boundaries.

·         Private-sector involvement can “kick start” projects.

·         With leadership at the state and local levels, governments can “make things happen.”

·         A “common sense” way of addressing transportation needs must be identified.

Representative Bill Shuster, U.S. House of Representatives

·         The federal government should be looking to the states for ideas and inspiration; that said, it is possible that the best thing that the federal government might do is “just get out of the way.”

·         In order to be successful, the federal and state governments need to work together.

·         Time is money, and continued investments are needed in infrastructure, including transportation; infrastructure is the “backbone” of the economy.

·         Inefficiency leads to higher costs.

·         The United States must move goods and connect the nation; otherwise, the United States will not be a nation.

·         There are three activities that government should perform for citizens:

§  provide security;

§  preserve justice; and

§  erect and maintain infrastructure.

·         Regarding transportation, legislators need to move forward on a bipartisan basis, and the federal government should give the states greater flexibility to move forward.

·         Some effort should be devoted to getting people off highways and into trains.

·         In order to compete in the global marketplace, exporters need an efficient system for moving their goods; infrastructure is “one tool in the toolbox” that contributes to competitiveness.

·         The private sector should be part of solutions.

2020 GAME PLAN: WHAT TOMORROW’S WINNERS NEED TO BE DOING TODAY

Matt Thornhill, Boomer Project

·         Historically, people were optimistic about the future; now, people are not sure about the future and are not convinced that their children will have a life that is better than their life.

·         If it were possible to predict the future with certainty, it would be possible to adapt and react; one aspect of the future that is almost certainly true is that there will be “bumps.”

·         Since predicting the future involves risks, it is possible to consider multiple scenarios: upside, downside and likely.

·         Regarding the year 2020, there are three “bankable meta trends” and three “actions steps” for which to prepare.

·         The three “bankable” meta trends are:

§  demographic – the future will involve fewer young people and more older people, and it is important to recognize that generations are not homogeneous;

§  societal – the “millenials” – who are “hypercollaborators” and have “a high rate of narcissism personality disorder” – are “rising,” and that generation “came of age” with Facebook, school violence, diversity, over-involved parenting, the Internet, the terrorist attacks of 11 September 2001 and recycling; and

§  cultural – “purpose” is replacing “profits” as a “driver.”

·         The three “action steps” are:

§  internal – organizations are stating, sharing and teaching their values, and are making them part of their culture and brand; employers may seek to hire people who already share their values;

§  external – it is important for people to live and fulfill their “organizational” and “individual” promise every day, which should be motivational; and

§  intentional – it is important to realize that generations differ, and that the generation of which individuals and employees are a part implies different behaviours.

ADVANCING CORRECTIONS REFORM

Steve Aos, Washington State Institute for Public Policy

·         Evidence-based programs are needed; evidence is required to determine what works and what does not work.

·         The state of Washington is using evidence to determine the programs that are successful in reducing crime rates.

·         The state of Washington is focused on a portfolio of programs that reduce crime rates and save tax dollars.

Ashbel T. Wall II, Rhode Island Department of Corrections

·         It is important to be responsible with the use of taxpayer funds.

·         One of the core costs associated with the corrections system is the cost of health care for inmates.

·         The inmate population is largely unhealthy, with communicable diseases, chronic illnesses, mental illnesses and substance abuse problems.

·         The U.S. Supreme Court has determined that inmates are entitled to the “community standard of care.”

·         In terms of process improvements, consideration should be given to:

§  electronic medical records;

§  engagement of third-party entities to process medical claims;

§  negotiated rates of reimbursement for hospital care;

§  Medicaid management information systems; and

§  review of in-patient hospitalizations.

·         In terms of the delivery of services, consideration should be given to:

§  chronic care clinics “behind the walls” to manage health care conditions;

§  specialists entering facilities for appointments as a means of reducing transport to doctors’ offices;

§  telemedicine; and

§  the use of nurse practitioners.

·         In terms of medication and equipment, consideration should be given to:

§  bulk purchases through pharmacy management companies;

§  a review of prescribed drugs;

§  adherence to formularies; and

§  a multi-state corrections consortium for purchases at reduced prices.

·         In terms of health care and prisoner re-entry, consideration should be given to:

§  recidivisim rates, which can be significant;

§  the contribution of a failure to address health care needs in “downward spirals”; and

§  the benefits of better health care coordination upon release from the corrections system.

STATES’ ROLE IN CYBERSECURITY

Matt Devost, Terrorism Research Center, Inc. and Georgetown University

·         There is an increasing number of threats, and the threats are frightening; that said, it is important to put threats into context.

·         Organizations and people should consider the following questions:

§  Who or what is your most likely attacker? For example, is it external, internal, a particular country, a specific interest group, etc.?;

§  What is it that an attacker would be most likely to target?

§  What would be the impact of the attack? For example, would it be critical, a nuisance, an embarrassment, etc.?

§  What are the vulnerabilities?

§  How should the most important systems be protected?

·         In order to manage risk, there is a need to think about threats and impacts.

·         It is important to identify the points that are the highest threat, impact and importance.

·         Critical systems and data include:

§  critical infrastructure;

§  public safety systems;

§  the personal data of citizens; and

§  financial transaction systems and related data.

·         Although there are no “silver bullets,” there are “silver concepts” that increase security; in this regard, consideration should be given to:

§  a critical data review;

§  assessment and self-awareness;

§  training and awareness;

§  mitigation and management;

§  response and measurement; and

§  threat intelligence and the sharing of information.

·         “Cyber” is not always focused on prevention; there is also a need to address incident response.

·         Although it may not be possible to prevent an event, it is possible to “manage and mitigate” better.

Respectfully submitted,