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COVID-19 and Cybersecurity
From the Document: "State cybersecurity concerns - critical for governors under normal circumstances - have only intensified during the COVID-19 [coronavirus disease 2019] pandemic. Malicious cyber actors have a history of exploiting the confusion and fear surrounding crises, which the current pandemic offers on an unprecedented scale. State agencies, critical infrastructure sectors, and the general public are experiencing waves of COVID-themed malicious cyber activity. The mass transition to remote work environments is a challenge for state networks while increasing their cyber vulnerability, providing threat actors even more opportunity. The stakes riding on states' abilities to prevent and protect its systems, staff, and entities within the state from cyberattacks is immense. A successful cyberattack on state networks or critical infrastructure, especially healthcare facilities, would cripple its ability to respond to and recover from COVID-19."
National Guard Association of the United States
McBride, Bill
2020-04-28
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Implementing Effective Social Distancing Policies to Mitigate Spread of COVID-19
From the Document: "As COVID-19 [coronavirus disease] is rapidly spreading throughout communities in the United States, policies promoting social distancing have been a critical strategy to 'flatten the curve' of infections to prevent overwhelming the medical system and allow time for states to accelerate testing, public health, and health system capacity. According to projections cited by the White House, the United States could face as many as 1.5 million to 2.2 million COVID-19-related deaths without strict social distancing measures, and 100,000 to 240,000 deaths even with such policies in place. Despite early evidence of slowing infection rates in states that have responded aggressively to implement social distancing policies, national data from Johns Hopkins University's Coronavirus Resource Center indicate that the strength of mitigation responses in the United States has not been sufficient to bend the curve of the epidemic compared with similarly affected countries that have implemented and enforced stay-at-home orders and other social distancing measures."
National Governors' Association
McBride, Bill
2020-04-07
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Gubernatorial Considerations for Continuity of Operations Plan (COOP) Implementation
From the Document: "Pandemics, emergencies, and other catastrophic events require governors and state and territory leaders to consider how they will continue to operate and deliver core services to the public. Spurred by the events of 9/11, COOP [Continuity of Operations Plan] planning describes the Mission Essential Functions (MEFs) of a state or territory government, as well as the process for preserving and maintaining them in an emergency. In the context of COVID-19 [coronavirus disease], governors should consider which government services should be sustained in the face of social distancing demands, potential reductions in staff due to illness, and supply chain interruptions. Reducing the number of services provided by a government does not indicate failure; instead, it allows governments to prioritize physical, human, and financial resources to support, sustain, and sometimes enhance MEFs and emergency operations. For instance, records management personnel may be moved from a shuttered (temporarily closed) DMV [Department of Motor Vehicles] to support state hospital administration. Implementation of COOP plans allows governors and state governments to continue the purpose of their public services and mitigate the impacts of COVID-19 on residents."
National Governors' Association
McBride, Bill
2020-04-10
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Strategies for COVID-19 Response for Older Adults and People with Disabilities
From the Document: "As governors consider ways to mitigate the spread of COVID-19 [coronavirus disease] and protect vulnerable communities, health care workers, and other service providers, targeted approaches for nursing homes, other residential facilities, and in-home and community services for older adults and the disabled are critical. This resource provides key considerations for governors and state leaders as they develop strategies for these populations and includes: (1) a high level review of considerations for governors; (2) a detailed briefing of considerations and related state examples; and (3) an appendix with quick links to additional resources, including relevant federal guidance."
National Governors' Association
McBride, Bill
2020-04-03
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Gubernatorial Strategies for Telehealth
From the Document: "As COVID-19 [coronavirus disease] continues to rapidly spread throughout the nation, states are taking sweeping actions to restrict individuals from congregating and encouraging self-quarantine to flatten the curve of the virus. One of the key strategies in this effort is telemedicine - allowing individuals to receive virtual care - which can reduce the spread of the virus and expand health care capacity by keeping potentially ill individuals in their homes, reducing exposure of health care workers and reducing the number of people needing care in facilities. Many states will need to take swift action to ensure that the providers in their states are ready and able to provide telemedicine in a manner that best addresses COVID-19. States may use a variety of vehicles to achieve this goal depending on existing authorities and flexibilities, including gubernatorial authority, regulation, and legislation (where necessary) in order to limit unnecessary interactions and reduce the number of new infections. To date, the federal government and many states have already taken steps to increase access to telehealth services by increasing the types of reimbursable covered services, reducing consumer costs, reducing participation requirements and barriers for providers, and increasing the modalities through which services may be offered via telehealth. However, there are many variations across states ranging from how Medicaid and private health insurance reimburses telehealth services, to what type of provider and what setting may be authorized for these services."
National Governors' Association
McBride, Bill
2020-03-20
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Overview of Section 1135 and Section 1115 Waivers
From the Document: "On March 13, President Trump issued an emergency declaration under both the 'National Emergencies Act' and the 'Robert T. Stafford Act' concerning the Novel Coronavirus and COVID-19 [coronavirus disease]. Department of Health and Human Services (HHS) Secretary Azar had declared a public health emergency under Section 319 of the Public Health Services Act on January 31. The president's declaration empowers the HHS secretary to authorize the Centers for Medicare & Medicaid Services (CMS) to take proactive steps to address key health system needs through Section 1135 waivers and Section 1115 demonstrations for disaster response. The purpose of the waiver authority is to allow a temporary relaxation of certain regulatory requirements so that CMS and states can ensure that sufficient health care services are available to meet the needs of individuals when and where an emergency is experienced. In determining what action may be needed, below are considerations for governors on the flexibilities available to states through section 1135 waivers and section 1115 demonstrations."
National Governors' Association
McBride, Bill
2020-03-30
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Gubernatorial Actions to Support Medical Surge Capacity
From the Document: "The coronavirus and COVID-19 [coronavirus disease] are spreading across the United States and experts predict significant disruption to the U.S. health care system. With hospitals typically operating at or near 100 percent capacity - particularly during flu season - the availability of facilities, equipment, personnel, and supplies can be limited. Federal- and state-level declarations of emergency provide governors a broad range of authorities to assist the health care system in meeting the surge in demand. The following are a selection of actions that may be within a governor's authority in various instances and settings."
National Governors' Association
McBride, Bill
2020-03-18
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Gubernatorial Strategies for Health Care Workforce and Facility Capacity
From the Document: "COVID-19 [coronavirus disease] is posing a serious threat to the nation's health care workforce. As cases continue to rise, there will be increasing demand and strain on the health care workforce in each state. Some states are already thinking creatively about expanding the available workforce as hospital beds are filled and health care workers are at capacity; other states are now preparing for the surge that will come in the next weeks or months. Furthermore, health care workers are at a higher risk of contracting the virus and requiring quarantine, meaning additional surge capacity may be needed to make up for lost capacity. In responding to COVID-19, there are several strategies that governors can deploy to maximize the capacity of the health care workforce in hospitals, nursing facilities, and at home to meet increasing demand. It is critical that state policies, health systems, and providers themselves are equipped to take precautionary measures to reduce risk of infection and ensure adequate supports for this finite and overstretched workforce."
National Governors' Association
McBride, Bill
2020-03-24
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Capacity for COVID-19 Testing -- Current Status and Considerations
From the Document: "As governors continue to lead in preventing the spread and mitigating the negative consequences of COVID-19 [coronavirus disease], significant limitations on testing supplies and laboratory testing capacity must be considered in short-term planning. Test availability and laboratory capacity to analyze specimens are increasing, but supply chain pressures, especially regarding seriously limited access to reagents, and other test equipment (e.g., swabs and viral transport media) and severe shortages of personal protective equipment (PPE) (e.g., N95 respirators, masks, gowns, gloves) are significantly limiting population-level testing approaches. [...] This memo addresses approaches governors may take to increase access to testing such as (i) expanding access to tests and laboratory capacity to process the tests, (ii) assertively working with the federal government and commercial suppliers to obtain test equipment and PPE; (iii) expanding drive-through testing options, and (iv) providing consistent testing guidance for providers and consumers in the context of limited resources."
National Governors' Association
McBride, Bill
2020-03-26
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Early Release from Incarceration in Response to COVID-19
From the Overview: "Correctional institutions are particularly vulnerable to COVID-19 [coronavirus disease 2019] outbreaks. As part of state and local COVID-19 response efforts, officials are taking actions to mitigate the spread of the disease and protect criminal justice-involved populations and correctional staff. These measures include amending agency policy (such as policies on visitation, hand sanitizer, copays, shared spaces, etc.), following 'CDC [Centers for Disease Control and Prevention] Interim Guidance on Management of COVID-19 in Correctional and Detention Facilities', and utilizing alternatives to incarceration consistent with public safety. As part of these broader COVID-19 correctional response efforts, state prisons and local jails are also releasing certain individuals from correctional facilities prior to the completion of their sentence. The health and safety of the public, correctional staff, and incarcerated individuals are core considerations when deciding to release certain incarcerated individuals early. So far, most action to release incarcerated individuals in response to COVID-19 has taken place through judicial mandate or through local decisionmaking at county jails. Recently, some states have moved to early release as well. The following outlines mechanisms for implementing early release for certain correctional populations, provides a summary of state and local actions, identifies key provisions of release decisions, and summarizes considerations noted by states around determining these actions."
National Governors' Association
McBride, Bill
2020-04-08
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Supporting K12 and Postsecondary Virtual Learning Environments
From the Summary: "This memo analyzes the need to expand access to and support around virtual learning methods as educational institutions move to online instruction. As schools, colleges, and universities across the country shutter for a few weeks, months, or until next semester due to COVID-19 [coronavirus disease 2019], many institutions are switching to virtual instruction and support services. Though this is a helpful tool to keep education moving during the shut-down, there are some challenges that governors can address: [1] Students and faculty may not have access to reliable broadband or equipment to access virtual learning; [2] Faculty and students may not be familiar with technology or techniques to effectively teach and learn, particularly on complex issues; and [3] Students need virtual options for on-campus resources for counseling, mental health, and other healthcare needs."
National Governors' Association
McBride, Bill
2020-05-01
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Pertinent Higher Education Provisions in the CARES Act
From the Background: "The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) includes an Education Stabilization Fund of $30.75 billion. Funding is available until September 30, 2021 and is intended to assist states as well as educational institutions and entities responding to COVID-19 [coronavirus disease 2019]. The purpose of this memorandum is to outline the higher education provisions in the appropriations (Part I) and authorization (Part II) portions of the stimulus package."
National Governors' Association
McBride, Bill
2020-03-26
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CARES Act & Emergency Appropriations for Coronavirus Health Response and Agency Operations: Workforce Provisions Summary and Analysis
From the Document: "Title II of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) contains detailed provisions on the design and implementation of Unemployment Insurance (UI) and other short-term unemployment compensation programs in response to COVID-19. For the purpose of this summary, these provisions are not included, with the exception of provisions related to the development of guidance in implementing these programs."
National Governors' Association
McBride, Bill
2020-03-27
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Additive Manufacturing Response to COVID-19
From the Introduction: "As the COVID-19 [coronavirus disease 2019] pandemic disrupts global supply chains and manufacturing operations, the medical community faces a critical shortage of certain devices and personal protective equipment (PPE), particularly those essential for treating respiratory diseases like COVID-19: test swabs, respirators, ventilators and face shields. One potential solution to help bridge the gap between healthcare systems and their suppliers is the additive manufacturing community. Also known as 3D [three-dimensional] printing, additive manufacturing (AM) is a digitalized production process that layers material to build up a component into a finished product. The 3D printing process is a flexible approach to manufacturing, with labs small and mobile enough to be established in a basement if necessary. With thousands of labs scattered around the country needing only the appropriate design blueprints and material to begin producing, AM has the potential to be a rapid, localized response option for healthcare systems in need. The AM community is proactively seeking ways they can support the crisis response, including creating and distributing head bands for face shields, ventilator splitters, test swabs and replacement parts for ventilators and respirators. As the AM community increasingly looks to serve as a stop-gap measure to bridge the equipment shortage, state governments should be aware of any sterilization and quality control issues surrounding deployment, potential legal concerns, and how they can assist in scaling production and distribution."
National Governors' Association
McBride, Bill
2020-04-15
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COVID-19 Responses in the Juvenile Justice System
From the Document: "As the number of COVID-19 [coronavirus disease 2019] cases increases, governors are taking action to limit the spread of this disease, including coordinating with correctional leaders to prevent and limit the spread and risk to justice-involved populations. As an extension of the call NGA [National Governors' Association] recently held for the Criminal Justice Policy Advisor (CJPA) network on state responses for adult correctional facilities, this memorandum summarizes promising practices and potential strategies that governors and state leaders may consider adopting to address the impact of COVID-19 in the juvenile justice system. Topics covered include releasing youth from juvenile facilities, limiting new admissions to facility, limiting in-person visitation and contact in community supervision, and continuing education and programming."
National Governors' Association
McBride, Bill
2020-03-30
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Dual Credit in the Time of COVID-19
From the Background: "Students enrolled in dual credit courses are relying upon multiple stakeholders to execute the transition from the classroom to virtual learning. Questions of where to find resources to continue their education at home, if they can obtain a refund due to individual circumstances that no longer allow them to remain enrolled, and program quality should be top-of-mind for governors and state policymakers. Answers to these critical questions can largely depend on the individual governance structures in place that grant different levels of authority to the state, school districts, and institutions. The purpose of this memorandum is to provide governors and state policymakers with resources that can help inform decision-making on issues of governance, unique circumstances and program quality, and financing. It also provides early examples of state and institutional action on this front."
National Governors' Association
McBride, Bill
2020-03-25
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Operational Coordination for COVID-19 Response and Recovery
From the Introduction: "As the COVID-19 [coronavirus disease 2019] pandemic grows in scale and complexity, so does the number of state, federal, local, nonprofit, and private assets deployed to assist in the response. Governors play an important role in ensuring these partners can, and are, working together to define strategies and achieve goals. This operational coordination enables unity of effort, reduces misuse, errors, and duplication of activity, and optimizes the amount of human, physical, and financial resources available for various missions. To be effective, operational coordination will need to be applied across all phases of the COVID-19 crisis lifecycle, from immediate response and long-term recovery to mitigation of future outbreaks."
National Governors' Association
McBride, Bill
2020-04-21
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Adjustments to Work-Based Learning in Response to COVID-19
From the Summary: "Education and training programs across the country have been interrupted as a result of the coronavirus (COVID-19). Work-based learning programs such as apprenticeship, internship, and career and technical education (CTE) connects on-the-job learning (OJL) with related technical instruction (RTI). This memo looks at how states are regulating work-based learning programs during the crisis while many instruction sites, both in the classroom and at the workplace, are closed. It looks at what states are doing to regulate the RTI and OJL components of work-based learning programs and assure financial stability to individuals who were previously relying on wages received as part of their interrupted OJL experience."
National Governors' Association
McBride, Bill
2020-06-08
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Postsecondary Strategies for COVID-19
From the Summary: "Postsecondary education in states is a complicated ecosystem that connects oversight of adult basic education, workforce training programs, veterans' programs, community colleges, universities, and student support structures. In order to respond effectively and efficiently to the COVID 19 [coronavirus disease 2019] pandemic, it is necessary to align these systems."
National Governors' Association
McBride, Bill
2020-03-30
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Short-Time Compensation Programs as a COVID-19 Response and Recovery Strategy
From the Document: "This memo provides governors and state officials with an overview of the Short-Time Compensation (STC) program - also known as work-sharing - and opportunities for developing, promoting, and expanding state STC programs during the COVID-19 [coronavirus disease 2019] crisis."
National Governors' Association
McBride, Bill
2020-06-25
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Access and Functional Needs Considerations for COVID-19 Response and Recovery Planning
From the Background: "The COVID-19 [coronavirus disease 2019] pandemic presents unique challenges for the access and functional needs (AFN) of individuals with temporary or permanent challenges accessing or receiving medical care, support services and/or accommodations before, during or after a public health emergency. These individuals have existing needs to be considered in emergency response and recovery plans and may be disproportionately impacted by the pandemic (e.g., at increased risk for infection, morbidity and mortality depending on their current circumstances). In addition, emergency response activities and mitigation policies themselves may inadvertently create new disruptions to accessing care and supports for this population. [...] Governors play an essential role in leading development and implementation of inclusive emergency response throughout all phases of the COVID-19 crisis. To do so effectively, governors could direct emergency managers to partner with relevant cabinet officials and key stakeholder partners to coordinate cross-sector approaches to achieve AFN-inclusive emergency planning. This memo provides state emergency planners with high-level administrative and policy considerations for that purpose."
National Governors' Association
McBride, Bill
2020-05-06
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Cost Share Considerations for FEMA Public Assistance Grants
From the Introduction: "There are many grant programs available through federal agencies to support disaster response and recovery activities. On March 13, 2020 when President Trump declared a nationwide emergency pursuant to Sec. 501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, he directed FEMA 'to assist state, local, tribal, territorial governments and other eligible entities with the health and safety actions they take on behalf of the American public' and activated the FEMA Public Assistance (PA) program. The reimbursable activities were limited to Category B, emergency protective measures, and include costs related to the activation of State Emergency Operations Centers, National Guard missions, law enforcement and other measures necessary to protect public health and safety, as well as emergency purchase and distribution of food and non-congregate sheltering. Reimbursements for these expenses will be provided at a 75 percent federal cost share; the remaining 25 percent of costs must be covered by the state and/or its localities."
National Governors' Association
McBride, Bill
2020-05-20
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Steps to Address Food and Financial Insecurity for Individuals and Families in Response to the COVID-19 Pandemic
From the Summary: "This memo looks at what system level changes governors are making to address food and financial insecurity, including support for affected workers, as a result of COVID-19 [coronavirus disease 2019]. This memo is part of an NGA [National Governors' Association] checklist that provides considerations for governors in preparing for, responding to, and recovering from, the spread of the virus. It is not intended to be an exhaustive list, but rather to highlight key steps that states may consider to protect public health and address other consequences, and offer resources to support state actions."
National Governors' Association
McBride, Bill
2020-04-21
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Governor Actions to Address PPE and Ventilator Shortages
From the Document: "The COVID-19 [coronavirus disease 2019] pandemic has led to a surge in global demand for critical personal protective equipment (PPE) and medical equipment, most notably mechanical ventilators and related supplies. In the United States, rapid transmission of COVID-19 has exhausted state and local resources, and stores of PPE in the Strategic National Stockpile (SNS) have been fully committed. While federal officials contend that state needs for PPE and ventilators can be addressed through the private market, the global shortage and lack of coordination has pitted states against one another and other purchasers - including the federal government - in a bid to secure resources. Absent the federal government playing a stronger, more coordinated role, governors are leading efforts to address the urgent need for PPE and ventilators, with states increasingly working together to direct resources to parts of the country facing immediate shortages. This memo outlines actions governors have or may consider taking, as well as related federal and private sector efforts."
National Governors' Association
McBride, Bill
2020-04-13
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Governor Considerations Regarding Crisis Standards of Care
From the Document: "As part of state public health emergency preparedness initiatives, many states have developed guidelines or frameworks to address crisis standards of care (CSC). CSC are intended to help health systems and providers implement standardized and consistent approaches to allocate scarce resources throughout a region or state for triaging and treating patients impacted by a given emergency. Standardization is critical to ensure fairness in access to care throughout the affected area and to help limit the extent to which patients 'hospital shop' if there is perceived or actual differentiation in protocols for prioritizing care. Absent state guidance, hospitals will develop and follow their own policies. However, hospitals can incorporate guidance into their own operating procedures, decide when to activate, and decide when to deactivate."
National Governors' Association
McBride, Bill
2020-05-18
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Economic Recovery Planning & Resources to Support Businesses and Local Communities
From the Summary: "This memo reviews steps that governors can take to mitigate the economic impact of COVID-19 [coronavirus disease 2019], including efforts to provide rapid relief to businesses and communities. This memo is part of an NGA [National Governors' Association] checklist that provides considerations for governors in preparing for, responding to, and recovering from the virus. It is not intended to be an exhaustive list, but rather to highlight key steps that states may consider to protect public health, address other consequences and offer resources to support state actions."
National Governors' Association
McBride, Bill
2020-06-08
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State Tolling of Statutes of Limitations and Interstate Extraditions During COVID-19
From the Document: "NGA [National Governors' Association] received questions from several states about tolling of statute of limitations and interstate extraditions during the COVID-19 [coronavirus disease 2019] outbreak. The following memorandum provides information on recent state actions to address these issues."
National Governors' Association
McBride, Bill
2020-03-23
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