NCSL Podcasts

Emergency medical services face significant challenges in rural America. Just one is the time it takes to summon an ambulance. While most people living in urban and suburban areas expect an ambulance to show up within minutes of making a 911 call, the situation is very different for about 4.5 million Americans who live in ambulance deserts, according to a nation study conducted by Maine Rural Health Research Center and the Rural Health Research & Policy Centers. Those folks can expect to wait 25 minutes or more for emergency services to arrive. 

We sat down with two experts on the subject -- Dia Gainor, executive director of National Association of State EMS Officials, and Davis Patterson, director of the WWAMI Rural Health Research Center at University of Washington—to discuss that and other challenges to EMS in rural areas. Other issues they discussed included the severe workforce challenges in staffing rural EMS services, the role of legislatures in addressing rural EMS needs and the promise of community paramedicine in addressing both emergency and nonemergency care in rural areas.

RESOURCES

• Ambulance Deserts: Addressing Geographic Disparities in the Provision of Ambulance Services, Rural Health Research Gateway (May 2023)
• Beyond 911: Expanding the Primary Care Role of First Responders through Community Paramedicine
• Community Paramedicine: Connecting Patients to Care and Reducing Costs
• EMS Legislative Database
• The EMS and Community Paramedic Workforces Respond to COVID-19, WWAMI Rural Health Research Center (June 2023)
• The National Association of State Emergency Medical Services Officials
• State Actions To Address EMS Workforce Shortages
• You might need an ambulance, but your state may not see it as ‘essential,’ Stateline (September 2023)
• WWAMI Rural Health Research Center

Health care costs in the U.S. over the last 20 years have grown faster than the cost of other goods and services. Commercial health care costs, which include about half the health care market, have grown faster than Medicaid and Medicare spending.

Our guest on this episode is Alyssa Vangeli, a senior consultant with Bailit Health, a consulting firm in Massachusetts where she works with states to provide health policy analysis and consulting around the commercial health market. Vangeli explained what's driving the increase in costs, which segments of the health care economy are seeing the greatest cost increases, and the efforts by the federal and state governments to better understand the cost drivers and try to contain them. She also offered examples of what different states are doing and the success of those efforts.

Resources

• 2023 Health Costs Seminar, NCSL
• Bailit Health
• Health Costs, Coverage, and Deliver State Legislation, NCSL
• Health Policy Snapshot: Addressing Commercial Health Care Prices, NCSL
• State Actions to Control Commercial Health Care Costs, NCSL
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On this episode, Tim Storey sat down with Bruce Mehlman, founder of Mehlman Consulting, a D.C-based bipartisan lobbying firm whose clients include Walmart, AARP, Boeing and the Mayo Clinic. Mehlman’s perspective is also shaped by his experience as an assistant secretary of Commerce in the George W. Bush administration and time in private industry.

Mehlman has a savvy, insider’s take on how Washington works and sees the day’s events with a historical perspective that is often missing from our political analysis. 

Mehlman and Storey talked about the forces shaping our political world, the turn to populism in recent years in numerous countries the challenge that poses to our institutions. They also talked about Mehlman’s slide decks, that over the years have become well-known among policy types for their clear, data-driven, often humorous analysis of political, economic and social trends. 

Resources

• Bruce Mehlman’s PowerPoint Decks
• Mehlman Consulting

The ability to forecast how an infectious disease like COVID-19 will behave is a critical tool for public health officials.

On this podcast, we sat down with Dr. Roni Rosenfeld, a computer scientist and a leader in the field of disease forecasting. Rosenfeld leads the machine learning department at Carnegie Mellon University in Pittsburgh and also works with Carnegie Mellon’s Delphi Research Group, which is one of several organizations that are part of the newly developed Outbreak Analytics and Disease Modeling Network established by the Centers for Disease Control and Prevention. 

Rosenfeld explained that, over more than a decade, researchers working on disease forecasting have taken weather forecasting as their model in creating usable tools to better understand the path of infectious diseases. He explained the type of data disease forecasters use – everything from hospital records to Google searches—to develop their forecasts and how that information can help those in health care. He also discussed why it’s important for legislators and others in state government to understand how to use and interpret disease forecasting.

Resources

• Machine Learning Department, Carnegie Mellon University

Safeguarding energy systems from cyberattacks in a growing concern in the U.S. The Colonial pipeline ransomware attack a few years ago and some other high-profile incidents caught the public’s attention. But as the guests on this podcast point out, energy systems are facing an increasing number of attacks. 

On the podcast to discuss the situation are Lynn Constantini, a cybersecurity expert with the National Association of Regulatory Utility Commissioners, and Patrick Miller, CEO and owner of Ampere Industrial Security who brings more than 35 years of experience in the security field to the discussion. 

While the federal government has some regulatory authority over utilities, state legislatures have a key role in this area through their oversight of public utility commissions. Since the start of 2021, states introduced nearly 500 bills and passed 99 measures related to energy security as of August 2022.

Constantini and Miller discussed the rise in threats and attacks, the type of attacks that are most common and the difference between attacks on information technology, or IT, and operational technology, or OT. They also discussed the steps states already have taken to counter cyberattacks.

Resources

• 2021-2022 Energy Security State Legislative Review: Cybersecurity and Physical Security, NCSL
• Ampere Industrial Security
• Cybersecurity, Energy Security and Emergency Response, U.S. Department of Energy
• National Association of Regulatory Utility Commissioners
• North American Electric Reliability Corporation, Cybersecurity Standards

Reid Wilson is the founder and editor of Pluribus News, a 10-month-old news platform that focuses on the states and the policy trends that start there. On this episode, host Tim Storey sat down with Wilson to talk about how states are tackling some of their toughest issues: broadband, infrastructure projects, housing policy and artificial intelligence.

Wilson started out his career as an assistant to Chuck Todd on the National Journal’s Hotline and also worked for years at the Washington Post and The Hill before striking out on his own last year. He is an astute observer of state policy and politics as well as how the media covers those topics. In addition to state policy, Storey and Wilson also discussed the ongoing changes in the media coverage of legislatures.

Resources

• Pluribus News

Improv comedy may not be the first thing that comes to mind when you think of public policy, but Tane Danger suggests maybe it should be. Danger is the keynote speaker at this year's professional development seminar for two legislative staff groups—the Research Editorial, Legal and Committee Staff (RELACS) and the Legislative Research Librarians (LRL). The meeting is Sept. 19-22 in Minneapolis and at the state Capitol in St. Paul.

Danger co-founded the Theater of Public Policy in Minnesota, which combines serious public policy discussion with improv comedy. On the podcast, he discussed how the skills you need for improv, such as careful listening, are also skills that can help in a legislative environment. He also laid out how his two-day presentation to the legislative staff groups will involve both a talk and a workshop. 

Resources

• RELACS/LRL Professional Development Seminar
• Tane Danger website
• The Theater of Public Policy