NCSL Podcasts

This is our third podcast from NCSL’s Legislative Summit in Boston where the organization is celebrating its 50th anniversary.

Joining today's show with some some international perspective are Mark Daly, the chair of the Irish Senate, and Ruth Bajada, the deputy chief of mission for the European Union delegation to the U.S. 

On Monday and Tuesday I spoke with current and incoming presidents and staff chairs for NCSL. You can check those out wherever you get your podcasts. 

Resources

• Celebrating 50 years of NCSL
• NCSL's Legislative Summit

We're coming to you again today from NCSL’s Legislative Summit in Boston where the organization is celebrating its 50th anniversary.

Today's guests are Illinois Rep. Marcus Evans Jr., the incoming president of NCSL, and Lonnie Edgar, deputy director for Mississippi’s Joint Legislative Committee on Performance Evaluation and Expenditure Review and the incoming NCSL staff chair. They will both assume their new positions on Wednesday at the NCSL Business Meeting.

Resources

• Celebrating 50 years of NCSL
• NCSL's Legislative Summit

For today's episode, we're podcasting from NCSL’s Legislative Summit in Boston where the organization is celebrating its 50th anniversary.

We're positing podcasts Aug. 4, 5 and 6 with some voices from the Summit. Today our guests are  Utah Sen. Wayne Harper, the president of NCSL,  and John Snyder, the Transportation Committee staff administrator for the Kentucky Legislative Research Commission and the NCSL staff chair. 

Tomorrow, joining us will be Illinois Rep. Marcus Evans Jr., the incoming president of NCSL, and Lonnie Edgar, deputy director for Mississippi’s Joint Legislative Committee on Performance Evaluation and Expenditure Review and the incoming NCSL staff chair.

And on Wednesday, we'll sit down with two international visitors to get their perspective on the Summit and why working with state lawmakers is important for their nations.

Resources

• Celebrating 50 years of NCSL
• NCSL's Legislative Summit

This episode is the fourth and final show in a series celebrating and exploring the 50th anniversary of NCSL. 

On this episode, the focus is on legislators. Along with Senator Lee, two other lawmakers offer their perspective on the role of state legislator. Also joining the discussion are Tim Storey, the CEO of NCSL, two political scientists with deep knowledge of state legislatures and an NCSL researcher with results of the latest survey of legislators. 

Earlier episodes charted the history of legislatures in the U.S., how the institution of the legislature evolved and the critical role of legislative staff. 

Resources

• NCSL Marks 50th Anniversary of Strengthening States

Nearly 60 million people in the U.S. fall into the broad category of independent workers. Those include contract, temporary and gig workers. Their jobs do not fall neatly into employer-connected benefit systems, so policymakers increasingly are exploring benefits that are instead attached to the worker. 

Several states have enacted legislation allowing portable benefits to be set up in their state. Other states have created programs that offer automatic enrollment for employees without access to an employer-sponsored plan. All those efforts are aimed at expanding the ways people save for retirement and other needs. 

On this episode to discuss the issue are John Scott, director of the Retirement Savings Project at Pew, Kristen Sharp of the Flex Association and Karen Kavanaugh, who's working with Tufts University on the Working While Caring Initiative.

All three talked about how the worker benefits system can better serve people in the changing economy and provide them with greater financial security.

Scott laid out the scale of the challenge to improve financial security for Americans and Sharp discussed how portable benefits can help the people her group serves, the millions of people whose work is app-based and need a better system to receive benefits. Kavanaugh is focused on how benefits employers provide can be better shaped to help the tens of millions of people in this country with caregiving responsibilities. She's overseeing a pilot project that's exploring how smaller employers can build in the flexibility needed by many caregivers. 

Resources

• Portable Benefits for Independent Contractors: A Framework for State Policymaking, NCSL
• States, Employers Weigh Portable Benefits for Independent Workers, NCSL
• Workers Without Access to Retirement Benefits Struggle to Build Wealth, Pew

Our focus on this episode is wildlife crossings, underpasses or bridges built just for animals. Millions of animals are killed by vehicles annually on U.S. roads, ranging from large mammals like deer to smaller creatures like squirrels and birds. 

Animal-vehicle collisions result in about 200 human deaths and 26,000 injuries each year.

Joining the podcast to discuss the issue are Matt Skroch, director of Pew’s U.S. Conservation Project for the western U.S. and Alaska; Senator Mimi Stewart, a Democrat from New Mexico; and Rep. Katie Zolnikov, a Republican from Montana. 

Skroch explained the dimensions of the problem and why a nation with about 4 million miles of roadway has a significant challenge with vehicle-animal collisions. He also noted that states are studying and acting on the issue. 

In fact, nine states have enacted legislation related to wildlife crossings since 2020. I asked Senator Stewart and Representative Zolnikov, both of whom sponsored legislation on wildlife crossings in their states, to explain how state lawmakers are tackling the issue.

Stewart discussed the extensive planning that was done in New Mexico and how the fund received $50 million for this legislative year, the largest single amount appropriated for crossings in any state in a single year.

Zolnikov explained that Montana is No. 2 in vehicle-animal collisions in the country on a per capita basis and how the state is building up its fund to pay for crossings.

Resources

• Pew U.S. Conservation Project

Electrical co-ops and public power utilities provide service to about a 100 million Americans, including many rural parts of the nation and counties with persistent poverty. They have many of the same concerns about both physical and cybersecurity as investor-owned utilities, but different challenges in terms of terrain, staffing and resources.

On this episode, we focus on those challenges and how utilities in rural parts of the country are coping. Our guests are John Ransom, director of regulatory affairs for grid security for the National Rural Electric Cooperative Association, and Adrienne Lotto, senior vice president for grid security at the American Public Power Association. 

John and Adrienne discussed some of those unique challenges, how they work with state regulators and how something like high turnover in state energy offices can complicate their efforts. 

Resources

• American Public Power Association
• National Rural Electric Cooperative Association

A core tenet of the U.S. legal system is that an accused person must be competent to stand trial, which means a defendant can understand the charges against them and assist their lawyer in preparing a defense. In practice, defendants who need to be evaluated for competency often spend long periods in confinement because of a shortage of behavioral health services. When they are finally released, it's usually without ongoing care. 

On this episode, we spoke with three people who are involved in efforts to reform the process used to determine a defendant's mental competency: Indiana Supreme Court Chief Justice Loretta Rush and two Colorado legislators, Senator Judy Amabile, a Democrat, and Senator Byron Pelton, a Republican.

Chief Justice Rush explained the dimensions of the problem and discussed how a national task force on the issue developed. Policy recommendations. Senator Amabile, who has sponsored legislation on the issue talked about how Colorado ended up with a significant backlog of cases. Senator Pelton explained some of the unique challenges people in rural America face when dealing with behavioral health issues. 

Resources

• “Legislative Primer Series on Front-End Justice: Competency to Stand Trial,” NCSL
• “Juvenile Justice: States with Juvenile Competency Laws,” NCSL

Our focus on this episode is the behavioral health workforce. More than a third of the U.S. population lives in areas with shortages of psychologists, counselors and social workers, and nearly two-thirds of shortage areas are rural. Those workforce shortages occur during a period when many experts, including those at the Centers for Disease Control and Prevention, have concluded we have a mental health crisis. 

Data from the Substance Abuse and Mental Health Services Administration, or SAMHSA, indicates that for more than two decades half the people in need of behavioral health services in the U.S. did not receive them. 

Joining the discussion are Karmen Hanson, a senior fellow at NCSL; Brianna Lombardi, an assistant professor at the University of North Carolina at Chapel Hill; and Jeff Shumway, the director of Utah’s Office of Professional Licensure Review.

Lombardi discussed her experiences in researching the workforce shortage and explained some its complexities. Shumway gave a state-level perspective on how regulation can affect the workforce. Hanson broke down the efforts in legislatures to address the workforce issues.

Resources

• Allied Health Professions: Considerations for State Legislatures, NCSL
• Health Workforce Legislation Database, NCSL
• Health Care Workforce Resources, NCSL
• Scope of Practice Policy Database, NCSL

Biosimilars, a group of drugs that are similar to biologic drugs, which are medications produced using living organisms and are often used to treat complex medical conditions. Biosimilars were first introduced to the prescription drug market about a decade ago and as of March, the FDA had approved scores of products that may be used interchangeably for some of the most expensive brand-name biologic pharmaceuticals, treating conditions such as diabetes and cancer. 

While biologics make up only about 2% of prescriptions, they account for as much as 46% of total drug spending in the U.S.

The three guests on this podcast all have expertise on different aspects of this topic and discuss the use of biosimilar medicines in health care and the possible cost savings when they are used in place of originator biologic medications. 

Luca Maini is an economist who studies the pharmaceutical industry and is an assistant professor at Harvard Medical School. Chad Pettit is executive director of global government affairs for Amgen, a biotechnology company. Erin Glossop is a policy specialist at NCSL who follows state policies around pharmaceuticals.

Maini discussed his research into how the introduction of biosimilars into a market affects the price of brand-name biologics. Pettit explained the perspective from the biotechnology industry and how he thinks the industry will develop in the next several years. Glossop explained how some states are developing bipartisan policy around biosimilar access and efforts to find cost-savings these products might offer. 

Resources

• Amgen Biosimilars
• Assessing the Biosimilar Void in the U.S., IQVIA
• Biosimilars in the United States 2023-2027, IQVIA
• Biosimilar Uptake In The US: Patient And Prescriber Factors, Dongzhe Hong, et al.
• Coverage for Biosimilars vs Reference Products Among US Commercial Health Plans, James D. Chambers, et al.
• Exploring the Influence of Health Insurance Plans on Biosimilar Adoption Rates, Mariana Socal, et al.
• Factors Associated with Biosimilar Exclusions and Step Therapy Restrictions Among US Commercial Health Plans, Tianzhou Yu, et al.
• Luca Maini website