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Phased Allocation of COVID-19 Vaccines: State and Territorial Approaches
From the Document: "This table provides information on state and territorial plans for phased allocation of COVID-19 [coronavirus disease 2019] vaccines. As initial supply of COVID-19 vaccines is limited, Governors are focused on prioritizing certain high-risk populations for vaccine allocation through a transparent and equitable process. This table outlines state and territorial approaches according to Phases 1a-c, 2, and 3, however state Phases or Tiers may vary from this structure (e.g., additional phases or more condensed phasing) and such variations are noted where applicable for individual states. State planning for allocation to critical populations across Phases, including guidance for providers and the public, will continue to evolve and this document will be updated to reflect additional details as they are released."
National Governors' Association
2021-02-17
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COVID-19 Outbreaks: State Reporting by Setting
From the Introduction: "Data about the settings where COVID-19 [coronavirus disease 2019] infection occurs are critically important to understanding disease spread and informing policy decisions that promote public safety. These data will be particularly important as states roll out vaccination campaigns and look to target effective outreach, testing, and immunization in places where active disease-spread remains. To date, states vary widely in terms of whether and how they report COVID-related outbreak data, and what thresholds they use to define an outbreak. Additionally, there are no federal standards on the case thresholds for what constitutes an 'outbreak' or for notifying the public of setting-specific outbreaks (other than in nursing homes). [...] On behalf of the National Governors Association (NGA), and with support from the Robert Wood Johnson Foundation (RWJF), the State Health Access Data Assistance Center (SHADAC) developed this resource to identify states that have defined and are reporting setting-specific outbreaks as of November 2020 and highlight promising examples that others can look to as they consider adapting and expanding COVID-19 reporting. This resource also includes a summary of the status of related reporting on contact tracing and discussion of the impact of increasing levels of community spread on states' abilities to collect and report outbreak data."
National Governors' Association
2021-01
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Road Ahead: A Summary of State Economic Recovery Agendas
From the Executive Summary: "As Governors continue to focus on mitigating the COVID-19 [coronavirus disease 2019] pandemic and distributing vaccines, many are already asking key state policymakers and stakeholders to develop plans to achieve a robust and equitable recovery. This brief summarizes the leadership structures used to develop these plans, the processes they have followed, their areas of focus, and the key recommendations of seventeen state economic recovery agendas prepared in response to the pandemic and economic crisis of 2020-2021. The states whose efforts are summarized here are: Alaska, Arkansas, California, Connecticut, Hawai'i, Indiana, Kansas, Louisiana, Maine, Maryland, Massachusetts, Missouri, Tennessee, Utah, Washington, Wisconsin and Wyoming. The brief presents information on broad state economic recovery 'agendas' - including related publicly-available 'plans' - that often address issues state policymakers are most concerned about by proposing initiatives and strategies that could contribute to economic recovery. [...] Through a table format, the brief provides an overview of the following information on each of the seventeen highlighted state agendas/plans: [1] The state and lead state organization(s) or individual(s) engaged in the recovery planning; [2] The report/plan title, link and date, as well as any official press materials; [3] An overview of the effort's process and key focus areas; and [4] Recommendations/priorities or goals being addressed, and time horizons presented where applicable."
National Governors' Association
2021-02-19?
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Supporting a Trained Direct Care Workforce in Facility Settings During and After the COVID-19 Pandemic
From the Summary: "The COVID-19 [coronavirus disease 2019] pandemic exacerbated existing challenges in recruiting and retaining direct care workers. The Centers for Medicare & Medicaid Services issued several waivers to address staffing challenges across the continuum of care during the public health emergency, including a waiver to temporarily reduce certain training requirements, and some states have taken complementary action creating new flexibilities to quickly train and deploy a qualified workforce. While responding to urgent direct care staffing needs is a top priority for states in the short-term, it will be critical for states and employers to consider strategies for retaining this workforce when the waiver expires."
National Governors' Association
Block, Lauren; Maxey, Hannah; Medlock, Courtney . . .
2021-02
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National Governors Association [website]
"The NGA is the collective voice of the nation's governors. It provides governors and their senior staff members with services that range from representing states on Capitol Hill to developing policy reports on innovative state programs. In addition to information on State/Federal relations, the site provides homeland security emergency management materials, and state strategies."
National Governors' Association
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Pandemic Preparedness in the States: An Assessment of Progress and Opportunity
"This paper presents an overall assessment of the current level of pandemic preparedness in the states, based on the NGA Center's observations and an analysis of the information provided by workshop participants. It focuses specifically on preparedness in four sectors or disciplines that are common to all states--healthcare, commerce, education and public safety--and identifies five broad areas in which new or improved policies, procedures, capabilities or strategies are needed to improve overall pandemic preparedness." These areas are workforce policies, schools, situational awareness, public involvement, and public-private sector engagement. […] "Over the course of 2007 and early 2008, the National Governors Association Center for Best Practices (NGA Center) conducted nine regional pandemic preparedness workshops involving all 50 states, the District of Columbia, and four of the five U.S. territories. The workshops were designed to examine state pandemic preparedness, particularly in non-health-related areas such as continuity of government, maintenance of essential services, and coordination with the private sector. The workshops also examined the strengths and weaknesses of coordination activities among levels of government, both vertically (state-federal and state-local) and horizontally (state-state) as well as with the private sector."
National Governors' Association
2008-09
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Governors Guide to Public Health Preparedness
From the Introduction and Background: "Public health preparedness is a technical discipline that often requires subject matter expertise for proper interpretation and execution. This roadmap gives nonmedical practitioners, such as governors and homeland security advisors, the foundational knowledge they need to engage with their public health counterparts so that they can develop meaningful partnerships, cooperative plans and complementary policies."
National Governors' Association
Stienstra, Lauren; Zomorrodian, Reza
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State Approaches to Addressing the Infectious Disease Consequences of the Opioid Epidemic: Insights from an NGA Learning Lab
From the Executive Summary: "Governors remain at the forefront of creative strategies to curb the opioid epidemic and related challenges, including increases in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and other blood-borne infections related to injection drug use. Since 2010, HCV infections have been rising at an alarming rate, and the prevalence of HIV has increased among people who inject drugs. Injection drug-related outbreaks of HIV and HCV in communities such as Scott County, Indiana, are vivid examples of how these deadly and expensive-to-treat infectious diseases can threaten areas hard hit by the opioid epidemic."
National Governors' Association
Becker, Melinda; Alikhan, Shums; LaBelle, Regina . . .
2019-05
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Addressing the Rise of Infectious Disease Related to Injection Drug Use: Lessons Learned from Kentucky
From the Executive Summary: "With opioid-involved overdoses claiming the lives of 130 people every day across the United States, governors are looking to replicate best practices to address the epidemic and related challenges, including increased transmission of costly and devastating infectious diseases. This case study explores Kentucky's effort to establish syringe services programs, referred to as Harm Reduction and Syringe Exchange Programs (HRSEPs), in areas hardest hit by the opioid epidemic. The first southern state to authorize syringe services programs, Kentucky has established more than 50 HRSEPs to curb infectious disease transmission, provide basic health care services and establish new pathways to substance use disorder treatment and recovery for people who inject drugs."
National Governors' Association
2019-05
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Defense Production Act & Executive Action Taken in Response to COVID-19
From the Executive Summary: "The Defense Production Act (DPA) ['50 U.S.C. 4501 et seq'] grants the president a broad set of authorities to influence domestic industry in the interest of national defense, which defined broadly, includes preparing for and responding to military conflicts, emergency preparedness activities under the Stafford Act, acts of terrorism or continuity of government operations. President Trump has executed three Executives Orders (EO) and four Presidential Memoranda invoking the DPA in response to the novel coronavirus (COVID-19)."
National Governors' Association
2020-04-06
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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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Resources for Tracking the Novel Coronavirus (COVID-19) and Assessing State Authorities
From the Document: "The following memo outlines the current situation regarding the novel coronavirus, recently named COVID-19, and provides an overview of select legal authorities that may be exercised to prevent and respond to COVID-19 and other public health threats. NGA [National Governors' Association] will be providing more information and forums for state leaders to discuss COVID-19 issues on upcoming calls. Details will be forthcoming. Please note that this is a rapidly evolving situation and this memo will be updated accordingly."
National Governors' Association
2020-02-13
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Overview of State Actions on Business Closure and Personal Movement Restrictions in Response to COVID-19
From the Executive Summary: "As the number of COVID-19 [coronavirus disease] cases increases, governors are taking action to limit the spread of this disease. Business closures, designations of 'essential' businesses, and restrictions on movement (e.g., stay at home/shelter in place orders, curfews, etc.) are measures that can be taken at the state or local level to protect individuals from public health threats while ensuring continuity of essential functions and critical workforces. Governors possess significant powers and authority relating to the implementation of business closures, designations of businesses, and personal movement restrictions during emergency periods. The purpose of this memo is to share information about how governors are addressing freedom of movement in their states in response to COVID-19. Given these exigent circumstances and shifting dynamics, NGA [National Governors' Association] recommends that governors, their advisors, and other state officials work closely with legal counsel and private sector partners when: 1) Considering and implementing business closure orders and personal movement restrictions; 2) Classifying 'essential' businesses and/or personnel; 3) Coordinating with federal partners on guidance; 4) Collaborating with local partners on state-supported and locally implemented closures, where appropriate; and 5) Coordinating and collaborating with stakeholders upon the lifting of closures and designations."
National Governors' Association
2020-03-24
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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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Governor Guidance on the Energy Sector During COVID-19 Response
From the Document: "This memo serves to provide guidance to governors on how they can best support and protect the energy industry during the COVID-19 [coronavirus disease] pandemic. It highlights three areas governors should consider to ensure energy continuity and shares the energy industry response to COVID-19. NGA [National Governors' Association] has been in conversation with the U.S. Department of Energy and the energy industry to collect much of this information."
National Governors' Association
Lauf, Dan; Taylor-Anyikire, Alyse; Cimino, Emma . . .
2020-03-25
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Reference Chart on State Essential Business Designations
This document contains specific essential business designations as implemented in every state due to coronavirus (COVID-19) outbreak.
National Governors' Association
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Coronavirus: What You Need to Know
The webpage contains information including: " [1] Current Information On The Status Of COVID-19 [coronavirus disease] In The United States And Abroad, [2] What Actions States/Territories Have Taken To Address It, and [3] The Latest Efforts By The Federal Government."
National Governors' Association
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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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Planning for Concurrent Emergencies
From the Background: "Given the protracted nature of the COVID-19 [coronavirus disease 2019] pandemic, states will likely experience additional, simultaneous emergencies concurrent with additional outbreaks of the virus. Experts are forecasting an above-average season for hurricane activity across the Atlantic as well as an above normal wildfire risk for the states in the Pacific Northwest. Extreme heat may present a nationwide threat and most states are likely to experience above average temperatures for many months of this year. Earthquakes, targeted violence, and cybersecurity incidents know no season and pose persistent risk. Responding to and recovering from these disasters independently presents a significant challenge to states, notwithstanding the already staggering effects of COVID-19 on human, financial, and physical resources. Governors will need to work across the emergency management enterprise to properly prepare for a confluence of events that will strain their already burdened systems to ensure that their states are ready to protect lives and property. This memorandum provides: [1] Actions for Governors Looking to Bolster Emergency Preparedness; [2] An Overview of the Planning Considerations for Simultaneous Emergencies."
National Governors' Association
2020-06-01
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Unemployment Insurance During COVID-19
From the Summary: "Businesses across the country are closed in response to the spread of COVID-19 [coronavirus disease 2019]. Unemployment assistance has typically been available only to 'traditionally-employed' workers, and for state-determined timeframes with stipulations requiring that they actively look for work. Given the circumstances surrounding the COVID-19 pandemic, the U.S. Department of Labor (DOL), the White House, and states are working together to provide flexibility and additional support to workers of all backgrounds who have become unemployed as a result of COVID-19. [...] This memo describes: [1] What current unemployment assistance flexibilities exist under the CARES [Coronavirus Aid, Relief, and Economic Security] Act; [2] What states are doing to increase UI [unemployment insurance] staffing and system capacity; [3] What governors are doing to further improve access to UI; and [4] What governors can do to communicate UI challenges and opportunities to the public, to help reduce public uncertainty that further overwhelms the UI system."
National Governors' Association
2020
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School Nutrition and Meals Programs During K-12 School Reopening
From the Introduction: "Due to the COVID-19 [coronavirus disease 2019] pandemic and corresponding economic decline, the number of Americans experiencing food insecurity has skyrocketed in the United States. According to surveys administered by the Urban Institute and the Brookings Institution in Spring 2020, approximately one in five parents living with children have experienced food insecurity due to the pandemic, and rates of food insecurity are even higher among Black and Hispanic households. As with many social services, schools are critical sites in our nation's child nutrition infrastructure by offering breakfasts and lunches to children and distributing millions of subsidized meals to low-income students every day. With the closure of schools in Spring 2020, however, many children and families lost access to these meals, with one recent piece of research suggesting that only 61 percent of families whose children usually receive free or reduced-price school meals continued to receive meals during the closures. In the face of this national challenge, it is critical for education leaders at the state and local levels to consider how school meals can be effectively distributed to children and families when schools reopen in the fall, regardless of whether the mode of instruction is in-person or online. To support governors and state education leaders, this memo offers a synthesis of key school nutrition guidance and considerations across states' school reopening plans and includes links to relevant national resources on this topic."
National Governors' Association
Casalaspi, David; Kannam, Jesse
2020-07-31
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Preparing for the COVID-19 Vaccine and Considerations for Mass Distribution
From the Background: "The emergence of the COVID-19 [coronavirus disease 2019] pandemic has created unprecedented public health challenges and spurred a global race to develop and distribute one or more viable vaccines. The challenge of vaccine development is matched by the challenge of vaccine distribution; once discovered and produced, it must be delivered and dispensed to the population writ large. Although a vaccine is not yet available, lessons learned from the acquisition and distribution of COVID-19 diagnostics and therapeutics suggest that governors may want to begin addressing the challenges of mass distribution before its arrival. Immunizing the U.S. population against COVID-19 will likely require the single largest vaccination campaign ever undertaken and governors will play a key role in bringing together leaders from their state public health, immunization, and emergency management systems to design and execute the operation. As with many COVID-19 activities, a 'whole of government' response, with broad participation by health and human services, economic development, education, and public safety agencies, as well as private sector partners and the public, will be critical to its success. This memorandum provides: [1] Actions for Governors Preparing for Mass Distribution of a Vaccine; [2] Overview of Planning Considerations for Mass Distribution."
National Governors' Association
2020-08-03
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Strategies to Address the Need for Personal Protective Equipment as States Gradually Reopen
From the Overview: "As states and territories gradually reopen their economies and relax social distancing rules meant to slow transmission of COVID-19 [coronavirus disease 2019], there remains widespread demand for personal protective equipment (PPE), including respirators (e.g., N95 respirators), masks, face shields, goggles, gowns and gloves. [...] To better inform this memo, the National Governors Association (NGA) surveyed states to explore and understand their activities in the areas of PPE stockpiling and procuring or paying for PPE and/or cloth face coverings for: those in the state's care (e.g. foster care, corrections); state employees; small businesses; and low-income households. A total of 12 states and territories responded to this survey, and further information on their responses for each area are highlighted throughout this memo. NGA also engaged with several external partners to better understand the supply chain and have reflected some of those perspectives in this memo. As such, this memo serves to showcase the landscape of current state strategies to obtain PPE, from stockpiling activities to the PPE needs of small businesses and provides only limited considerations for future PPE efforts."
National Governors' Association
2020-07-28
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Information and Guidance on Supporting On-Demand Workers Through the COVID-19 Crisis
From the Document: "This memo provides governors and state officials with an overview of the key issues related to on-demand workers during the COVID-19 [coronavirus disease 2019] crisis. For the purposes of this memo, 'on-demand workers' is a broad term meant to include those workers who do not receive a W-2 [Wage and Tax Statement] tax form for some or all of their compensated work, like entrepreneurs and the self-employed. Research compiled by NGA [National Governors' Association] estimates that approximately three-in-ten Americans engage in some way with on-demand work, and around one-in-ten Americans engage in on-demand work as a primary source of income. On-demand workers are uniquely vulnerable. They are among those most likely to be exposed to the novel coronavirus, as well as be adversely impacted by the longer-term economic impacts of this crisis."
National Governors' Association
2020-06-01
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Supporting State Behavioral Health Systems During COVID-19 Response and Recovery
From the Background: "The COVID-19 [coronavirus disease 2019] pandemic is having immediate and long-term impacts on behavioral health (i.e. mental health and substance use disorder) systems in all states. Governors and their senior health and human services advisors play an essential role in incorporating a behavioral health strategy into the state COVID-19 response and recovery approach. [...] This paper identifies for Governors the key issues that are currently challenging state behavioral health systems, along with actions that state agencies may consider to support and sustain behavioral health services. Many of the issues identified below are still emerging and state and federal actions will require ongoing follow up to determine outcomes."
National Governors' Association
