Month: August 2017

Making the Census Count: How Regions Can Help

Although 2020 is a few years away, preparations are already in full swing for the next Census. The groundwork that the U.S. Census Bureau is laying out today will affect the accuracy of the 2020 Census across the country.

The Census Bureau is up against a significant accuracy issue: past Census reports have historically undercounted certain populations in the United States. These groups include young children, minorities, and low-income communities. The Census Bureau is once again concerned about this problem occurring in the next decennial Census count.

Why is this significant for NARC members? The George Washington Institute of Policy reports that there are several hundred federal financial assistance programs and sixteen large federal programs that rely on Census data to disperse funds to states and local areas. These programs include funding for housing, health care, transportation, education, and food assistance that your communities rely on. The Census count also determines the number of seats each state has in the U.S. House of Representatives. You may also use Census data to make decisions about your region based on how the population is changing.

The Coalition on Human Needs recently hosted a webinar that highlighted why it is essential for local and state governments, advocacy groups, and the federal government to work together to ensure that the 2020 Census is accurate. The following is a summarization of the points presented during the webinar about the 2020 Census.

Policy and Operational Challenges

The Census Bureau is currently facing a ‘perfect storm’ of policy and operational challenges. The administration, Senate, and House have all proposed approximately $1.5 billion in funding for the Census Bureau in fiscal year 2018. However, the agency needs at least $1.8 billion to carry out all its 2020 Census activities. Congress has also capped the 2020 Census cost at the 2010 Census level, which doesn’t account for increases in the U.S. population over the last decade. The current political climate has also led to a new threat: an amendment to add citizenship and legal status questions to the 2020 Census. This has produced participation fears in many communities.

To make up for the gap in federal funding, the Census Bureau has tried to streamline its operational processes. This comes with its disadvantages. Having half the number of local area census offices and census takers compared to the 2010 Census effort has posed a serious challenge of collecting information across the U.S. The push to make the Internet the primary response option produces a digital divide, especially for seniors and low-income communities that may not have access to a computer. There have also been cybersecurity concerns, promoting worries of having personal information at risk of being compromised.

Undercounted Groups

The following groups have typically been underrepresented in past decennial Census surveys:

  • Young children (ages 0-4)
  • Males
  • Renters
  • Hispanics
  • Hispanic males (ages 30-49)
  • Blacks
  • Black males (ages 30-49)
  • Native Americans
  • Pacific Islanders
  • Immigrants
  • Low-income households
  • The homeless
  • Highly-mobile groups
  • Individuals without Internet access
  • Selected minority-heavy areas

There are several possibilities of why certain populations are undercounted. Places of residence on the Census Bureau’s Master Address File may not be up to date. Some Census takers may not feel the need to include certain people that are living in their home full-time. An example of this could be a grandparent who did not include their grandchild as being a part of their household even though the child is living with them full-time. Complex households can cause confusion when filling out the Census, such as two households who share custody of one child. It is difficult to track highly mobile populations, like renters or the homeless, because their place of residence may often change. Language barriers and government distrust can also lead to underrepresentation in Census data.

What Can Local Governments Do?

The Census Bureau needs your help to make the population count as accurate as possible. Local governments should participate in the Local Update of Census Addresses (LUCA) Operation. LUCA relies on states, counties, cities, townships, and Indian reservations to review and comment on the Census Bureau’s address list before the 2020 Census. This ensures that all addresses and associated populations, which the Census cannot update from governmental data and third-party sources alone, are counted.

The Census Bureau encourages local governments to arrange for a regional planning agency or council of governments to conduct their LUCA review if they lack the resources to do it on their own. This is a clear call to action for regional councils to get involved. You should check with the local governments in your region to see if they can participate in LUCA. If not, you should offer them your assistance to make sure all the addresses in their jurisdiction are accounted for. Otherwise, you may be putting your region at risk for of receiving fewer federal dollars. Visit the LUCA webpage to learn more about LUCA and about how you can get involved.

On the community level, local leaders should encourage participation in the following ways:

  • Advertise the upcoming 2020 Census to your constituents.
  • Create opportunities to educate your community on how to accurately fill out the Census, and clarify misunderstandings for more complicated households.
  • Consider establishing a Census Complete Count Committee in your region. This is a voluntary group that brings community stakeholders together to increase awareness about the Census and urge people to respond.
  • Encourage leaders of your communities, especially those representing historically undercounted populations, to be a “trusted voice” advocating Census participation.
  • Promote the Census Bureau’s high confidentiality with information gathered from the surveys.
  • Craft culturally sensitive messaging about the Census to underrepresented communities.

The Opioid Crisis Was Declared a National Emergency: Here’s How Local Governments Can Help

Two weeks ago, the Trump Administration issued a statement that directed the executive branch to “use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.” This declaration couldn’t have come any sooner. The National Center for Health Statistics reported that in the third quarter of 2016, overdose deaths reached a record-breaking 19.9 people per 100,000. If this trend continues, our localities will need all the help the federal government can offer to battle this growing epidemic.

How bad is the opioid epidemic?

While education on the opioid crisis is getting better in the U.S., the crisis itself is still quite severe and doesn’t show significant signs of slowing. The National Center for Health Statistics (NCHS) data shows a sharp increase in overdose deaths in the first nine months of 2016. In 2015, the last full year of data available, the Centers for Disease Control and Prevention (CDC) found that 33,091 American deaths were caused by prescription and illicit opioids. Ninety-one people die from an opioid-related overdose every day. As many people are dying from opioid-related overdoses in one year than those that died during combat throughout the entire Korean War (1950-1953).

The U.S. is responsible for the majority of opioid consumption in the world – Cigna reports that Americans disproportionately take 80% of the world’s supply. An encouraging statistic from CDC is that the number of opioids prescribed in the U.S has decreased overall. However, the same report showed that three times as many opioids are being prescribed today than in 1999. There is also a lot of variation between counties. The CDC report showed that 22.6% of counties were still reporting opioid prescription rates higher than the national average, and that number is still rising.

Who does the opioid epidemic affect?

Chronic pain sufferers and veterans are two populations that are at high-risk for developing opioid abuse disorders. According to Congressman Tim Murphy, for the 50 million people in America that have chronic back pain, half are prescribed opioids for treatment. The National Institute of Drug Abuse reports that nearly 80% of heroin users have reported using prescription opioids prior to heroin, putting millions at risk unnecessarily. The Public Broadcasting Service (PBS) reported that 13 percent of U.S. veterans currently take opioids, and this population is twice as likely to die from an accidental opioid overdose.

What is perhaps the most difficult aspect of battling this epidemic? Opioid abuse disorders know no boundaries. It does not favor any demographic – age, educational level, socioeconomic status, or occupation. And it can develop in just about anyone, anywhere, at any time.

What does this national emergency declaration mean?

While the president has issued a statement declaring a national emergency for the opioid epidemic, a formal declaration has not yet been made. First, the Trump Administration must decide under which legislation they will declare the crisis. According to Governing magazine, this leaves the administration with two options they can employ individually or together:

  1. Emergency declaration through the Stafford Act. This option allows the president to declare the emergency. The Federal Emergency Management Agency (FEMA) provides financial and technical assistance to states and cities through this act. This option is typically used for natural disaster relief.
  2. Emergency declaration through the Public Health Service Act. This option allows the secretary of health and human services to declare the emergency. This would deploy medical professionals to the areas affected by the epidemic. This option is normally used in times of extreme public health crises.

Formally declaring a national emergency would have other positive implications for states and local governments. NPR pointed to four additional benefits under the national emergency declaration:

  1. Increased access to medication-assisted treatment. Federal rules could be waived on medications used to help treat opioid-related abuse and overdoses. The drug naloxone, used to treat opioid overdoses immediately, could be provided without a prescription. Restrictions on doctors to prescribe medication used to treat opioid addiction without a special certification could also be waived.
  2. More help to those on Medicaid. Regulation barriers could be removed to help Medicare patients. Under a national emergency, more Medicare patients may be able to get inpatient drug treatment. Medicare funding would also be provided to more treatment centers instead of limiting reimbursement to those with less than 16 beds.
  3. More money from Congress. The legislative branch may face increased pressure to provide money to help combat the opioid crisis after seeing executive action.
  4. States can request federal aid. Six states have already declared state emergencies in the face of the opioid epidemic. These states would be able to request federal funding for specific activities related to the opioid crisis.
What can local governments do to help combat the opioid epidemic?

A few weeks ago, NARC attended an event hosted by CQ Roll Call: Roll Call Live: Fighting the Opioid Crisis. Members of Congress, health care practitioners, insurance providers, nonprofit organizations, and local government representatives attended this discussion. Panels discussed what real-world solutions are available to fight this pressing issue.

These stakeholders proposed a very different solution to the crisis than the president. Trump supports a law-and-order approach that would crack down on federal drug prosecutions, sentence lengths, and illegal drugs entering the country (watch full comments here).

The local representatives and other stakeholders at the Roll Call Live event called for a much more holistic approach. You, our local government leaders, should tackle the crisis at all sides to help bring the opioid epidemic to an end. Law enforcement should only be an aspect of this fight. Focus on the following recommendations offered by the Roll Call Live stakeholders to address the opioid crisis:

  • We must do all we can to fight the stigma of opioid abuse. Local outreach is necessary to start the conversation of how common an opioid abuse disorder is, and that it is not a moral failing to develop an addiction. Communities should be educated on the process of opioid-related treatment and on how they can help.
  • Combine the efforts of patients, health care providers, governments, the pharmaceutical industry, insurance companies, and veterans to fight this epidemic. We all must work together and be on the same page.
  • Local governments are the closest in proximity to the epidemic and know the needs of their constituency. You should take the lead on this national issue and recommend to the federal government not to micromanage local efforts.
  • Ask your representatives and senators to dedicate federal funds towards opioid addiction treatment, outreach, and prevention. For every $1 that is spent on opioid addiction treatment, society saves $12.
  • Be aware of this evidence-based fact: to treat someone that has already developed an opioid addiction, a combination of medication-assisted therapy, mental health treatment, counseling, and maintaining relationships with the patient is the best way to battle the addiction.
  • Recommend to your local healthcare facilities to treat the individual – not the addiction. Treatments that focus on understanding a patient’s complex injury, creating an individual health care plan, monitoring a patient’s opioid use, and tailoring a treatment to help the patient achieve their personal life goals are most effective.
  • Counties, cities, and regions must develop better drug monitoring programs so doctors can monitor patient trends and know when to make an intervention. And records for this should be available across state lines.
  • Regions should work with medical professionals to focus on alternative methods of treatment and educate prescribers of the options. This should help with the issue of overprescribing opioids. Alternatives could include yoga, meditation, acupuncture, and mental therapy.
  • Communities must be unified against this crisis. Education against drug abuse disorders must start as early as elementary school. Your constituents should also be open to having treatment centers in their communities throughout your region.
  • Local leaders should help change the attitude of “quick fix” treatments in their communities.

The opioid epidemic is not going to end any time soon. It can take years for a patient to be completely weaned from opioids. The effects of the rise in addictions and overdoses are also going to have a ripple effect on families and communities in the middle of the crisis. Looking at evidence-based, long term strategies for these communities is the only way we’re going to be able to bring this crisis to an end.

NARC Federal Budget Call Recap: Where We Are Now and What to Expect in the Fall

Senators and representatives may be home for recess, but the issues they left in Washington will be here when they return on September 5. Not only will the issues be here, but the urgency to address them will have increased significantly.

Top issues that await them include: the adoption of a federal budget, 12 appropriations bills, legislation to raise the debt ceiling, and tax reform. It is also possible that health care legislation may come up for consideration again.

This is why NARC felt it was important to host a conference call last Wednesday on the current status of the federal budget with Deborah Cox, legislative director at the National Association of Counties (NACo); Michael Wallace, program director of federal advocacy at the National League of Cities (NLC); and NARC staff. We wanted to provide you, our members, with an update on where these urgent issues stand so that you can better understand how these legislative items may impact your regions, counties, cities, and towns. We also wanted to provide you with information on how to educate your representatives and senators about the impact their decisions are likely to have on your regions and, especially, the people who live there.

Here is what you need to know:

  • Congress is faced with three important legislative deadlines in September.
  • Adoption of the 12 FY 2018 appropriations bills.
  • Passage of legislation that raises the debt ceiling.
  • Adoption of a FY 2018 budget that will pave the road for tax reform legislation.
  • The budget and appropriations process, as in years past, is behind schedule. Congressional leaders are scrambling to adopt some type of comprehensive appropriations bill by the end of September to keep the government open. More than likely, Congress will be forced to pass a temporary continuing resolution through mid-December.
  • The final appropriations bills will not be adopted until later this year or early next year. It is likely an omnibus bill incorporating all 12 appropriations bills into a single bill will be passed. The omnibus bill is expected to increase defense spending substantially while cutting some non-defense discretionary funding.
  • When appropriations legislation is bipartisan, cities, counties, and regions benefit much more. Right now, the process is very partisan and the impact on cities, counties, and regions is not likely to be positive. However, it is likely that Republicans will need Democrats to pass any omnibus appropriations bill. This will help the process become bipartisan, possibly yielding a positive outcome.
  • Legislation that permits the Treasury to borrow funds to pay the government’s bills (commonly referred to as “raising the debt ceiling”) must be passed by September 29, or there is the risk that the federal government will not be able to pay its bills. This may cause the United States to default on its debt, forcing the federal government to shut down.
  • If Congress is to move forward with tax reform, it will need to adopt a FY 2018 budget. This will provide direction on how to move forward and give the Senate authority to adopt tax reform legislation with a simple majority (51 votes) rather than a super majority (60 votes).
  • Senators and representatives drafting tax reform legislation are seriously considering eliminating the state and local tax deduction and the tax-exempt status for municipal bonds to pay for massive tax cuts.
Appropriations Specifics

NACo, NLC, and NARC staff shared that while the president proposed to eliminate funding for the weatherization assistance program, the House and Senate would fund the program at FY 2017 levels ($211.6 million). The Community Development Block Grant (CDBG), which the president zeroed out, would be funded by the Senate at current levels and by the House at $2.9 billion, just $100 million below current levels. For the HOME Investment Partnerships Program (HOME), which the president sought to eliminate, the House would cut funding by $100 million to $850 million. Transportation Investment Generating Economic Recovery (TIGER) grant program, which the president and the House wanted to eliminate, would be funded by the Senate at 10 percent over current levels to $550 million. Another program on the president’s list to cut drastically was New Starts, which would be funded by the House at $1.75 million and by the Senate by $2.13 billion. The Low-Income Home Energy Assistance Program (LIHEAP), which would have been eliminated had the president prevailed, would be maintained by the House at current levels ($3.4 billion). Finally, while the president would have reduced funding for workforce development programs by $1.3 billion, these programs would be cut by the House by only $300 million.

More specific funding information is provided in the table below.

[table id=2 /]

What Can Regions Do?

Speaking with your representatives and senators is critical. Underline the importance of these programs and how funding cuts would impact your programs and constituents. Another option that sends a strong message to congressional leadership is to send letters and op-eds to your local papers about the impact these cuts will have.

There are multiple ways you can educate your senators and representatives on federal budget issues:

  • Set up a meeting with your representative(s) while they are in their home district.
  • Invite your local representative(s) to attend one of your regional or coalition meetings.
  • Encourage them to visit a site financed by federal funds to highlight what is being achieved and why continuous funding is essential.
  • Bring stakeholders together and invite your representative(s) to see the faces of those impacted by programs funded by the federal budget.

Every effort you take to reach out to your representatives and senators while they are in your regions will have an impact, and ultimately, make a difference. And at a time like this, when programs are on the chopping block and Congress wants to cut domestic spending in favor of defense spending, there is no greater time to get involved.

NARC will release a larger, more expansive guide to educating your members of Congress, which we will share with membership.

Please note that NARC plans on holding these budget calls approximately once each month for as long as they are necessary. Look for emails announcing these calls as the details become available. If you have not yet joined us for one of these calls, now is your chance.

NARC would like to thank Deborah Cox, Legislative Director at NACo, and Michael Wallace, Program Director for Federal Advocacy at NLC, for their presentations during the call. For more information, please contact Maci Hurley at maci.hurley@narc.org or Neil Bomberg at neil@narc.org.

Additional Resources Mentioned on the Call include:

NARC’s Notes from the Appropriations Call

NARC’s Newsletter: eRegions

NARC’s Newsletter: Transportation Thursdays

NARC’s Blog: Regions Lead

NLC’s Fight the Cuts Advocacy Toolkit

NLC’s FY 2018 Budget Tracker

NACo’s Summer Advocacy Toolkit

NACo’s One Pager on State and Local Tax Deduction

NACo’s Municipal Bonds Toolkit

Governor Finance Officers Association’s Report: The Impact of Eliminating the State and Local Tax Deduction