NCSL Podcasts

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.ResourcesPew 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. ResourcesAmerican Public Power AssociationNational 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.ResourcesAllied Health Professions: Considerations for State Legislatures, NCSLHealth Workforce Legislation Database, NCSLHealth Care Workforce Resources, NCSLScope 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. ResourcesAmgen BiosimilarsAssessing the Biosimilar Void in the U.S., IQVIABiosimilars in the United States 2023-2027, IQVIABiosimilar 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

Defiance is often thought as a negative trait, but as our guest on this podcast explains, it can actually be a positive force both in the workplace and in our lives generally. Dr. Sunita Sah, a professor at Cornell and an organizational psychologist, is the author of “Defy: The Power of No in a World that Demands Yes,” published earlier this year.Sah’s book explores why people say yes and go along at work and in other relationships in their lives, even when they want to say no. In this conversation, she explains how most people are conditioned to see defiance as a negative trait. Instead, she argues, defiance based on deeply held values can be a positive.She discusses how to evaluate a situation where you may want to defy, how we need to train ourselves to see defiance in a different light and why it is so difficult to make that transition. Sah also addressed defiance in the legislative workplace and the complications that can arise in a complex hierarchy. Sah also explained that while defying is not risk free, going along when you know you should object carries its own hazards.Sah will conduct a webinar on May 5 at noon MT as part of this year’s NCSL Legislative Staff Week. ResourcesDr. Sunita Sah’s website

Oral health care for children is required in every state under Medicaid or the Children’s Health Insurance Plan. But dental coverage for adults is optional. And while nearly every state provides some level of coverage for adults, what is covered and who is covered varies widely from state to state and even within states.Our first guest on this podcast is Ian Hedges, the director of Medicaid and Medicare program policy for the American Dental Association. Hedges explained how oral health care affects overall health and why different levels of coverage for adults under Medicaid can lead to higher costs later on for health complications that arise from neglected oral health issues. One study found that untreated oral health conditions can lead to health complications that cost the U.S. about $45 billion each year in lost productivity.Our other guests are Sen. Evan Vickers, a Republican of Utah, and Sen. Malcom Augustine, a Democrat from Maryland. Senators Vickers and Augustine explained how their states have approached broadening coverage for adults covered by Medicaid, the challenge in assembling a group of providers that will accept Medicaid reimbursement and some of the particular problems in providing care to those with low incomes and those living in rural areas.ResourcesMedicaid Adult Dental Benefits Are on the Move in 2024, CareQuestVariation in Use of Dental Services by Children and Adults Enrolled in Medicaid or CHIP, KFF

This is one in a series of podcasts celebrating the 50th anniversary of the National Conference of State Legislatures. On this episode we focus on legislative staff, the approximately 30,000 professionals who keep the trains running at this nation’s legislatures.While legislative staff outnumber legislators by more than 4 to 1, their role is often poorly understood by the public and even by their own families.  Yet the work they do from drafting legislation to providing bill research to keeping the IT systems running is critical to these institutions. We talked to a variety of staffers and others who reflected on the growth of staff, their critical role in providing nonpartisan professional advice to legislators, the changing role and challenges staff have faced especially in the last 50 years and what the future holds for them.ResourcesLegislative Staff, NCSLNCSL Marks 50th Anniversary of Strengthening States, NCSL

A new book published jointly by NCSL and the U.S. Election Assistance Commission is aimed at serving as a resource for election administrators, secretaries of state, state legislators and legislative staff. It will be available soon in digital form on the NCSL website. “Helping America Vote: Election Administration in the United States” was the focus of this podcast and features a discussion with Commissioners Ben Hovland and Donald Palmer.The EAC was established by the Help America Vote Act of 2002, which was Congress’ response to the problems with the 2000 election. The commission’s goals include adopting voluntary voting system guidelines, serving as a national clearinghouse for election administration and certifying voting systems. The commissioners are bipartisan. Hovland, chairman until earlier this year, is a Democrat, and Palmer, the current chairman, is a Republican. The commissioners discussed a variety of topics related to elections including the pros and cons of our decentralized voting system, the importance of election administration as a profession, the value of a bipartisan approach to election administration and who they hope will read this book. ResourcesElections and Campaigns Program, NCSL"Helping America Vote: Elections Administration in the United States"U.S. Election Assistance Commission

Medicaid is a program jointly funded by the federal and state governments. It provides health care coverage to nearly 80 million people, primarily those with low incomes, people who are living with disabilities or are in long-term care. On this episode we discussed the nuts and bolts of how Medicaid is financed and how states are handling some new challenges in the post-pandemic world. The pandemic affected both who Medicaid covered and the share paid by the federal and state governments.  In the first segment, NCSL’s Kathryn Costanza was joined by Akeiisa Coleman from the Commonwealth Fund to break down the details of how the program is funded, including how the federal-state share is determined for each state. They also discussed the key drivers of cost in the Medicaid system. On the second segment, guests Neda Jasemi from the National Association of Medicaid Directors, and Robin Rudowitz from KFF talk about what they are hearing from Medicaid officials around the country. They discussed how the post-COVID unwinding of patients who had remained on the rolls during the pandemic had significant effects on the program. They also discussed steps states are taking to try to ensure access for Medicaid patients and how states are preparing for any changes in the program at the federal level. ResourcesCommonwealth Fund/MedicaidHealth Costs, Coverage and Delivery State Legislation Database, NCSLHow We Pay for MedicaidKFF/Medicaid“Medicaid Financing 101,” NCSL“Medicaid Toolkit,” NCSLNational Association of Medicaid Directors“Results from an Annual Medicaid Budget Survey for State Fiscal Years 2024 and 2025,” KFF“State Legislatures Address Medicaid Coverage and Payments in the 2024 Legislative Session,” NCSL“State Tax Actions: 2024,” NCSL“Top five Medicaid budget pressures for fiscal year 2025,” NAMD