Though it likely won’t change much of the work already under way to protect western Lake Erie from excessive algal blooms, Michigan’s recent designation of its part of the watershed as “impaired” signals the importance of reaching new binational goals to control phosphorus runoff.
Every two years, as part of compliance with the Clean Water Act, all states must determine which of their water bodies are polluted and/or don’t meet water quality standards. They then submit their impairment list to the U.S. Environmental Protection. The new designation for western Lake Erie is due to the presence of extensive algal blooms and their harmful impact on aquatic life and other wildlife, Michigan environmental officials say. The blooms are the result of excessive levels of phosphorus.
When the problem of tainted drinking water created a public health crisis in the Michigan city of Flint, the state’s legislators had two clear missions to fulfill. First, fix the problem, with strategies — both immediate and longer-term — that help affected residents, bring back some normalcy to their lives, and then assist in the entire community’s recovery. Second, find ways to prevent the problem from ever occurring in another Michigan city.
And that idea of prevention has spread well beyond the borders of Michigan, with legislators in nearby states taking notice of the crisis and beginning to think more about the safety of the water supply in their own districts.
Struggling young readers in Michigan will get more instructional help to reach levels of proficiency under a new law that also could keep some of them from entering fourth grade. Signed this fall by Gov. Rick Snyder, HB 4822requires students to perform well enough on a standardized reading test in order to be promoted to fourth grade. However, the law does provide for some “good cause exemptions,” including if parents and school officials agree it is in the child’s best interests not to be held back.
Starting in January, states that chose to expand their Medicaid programs under the Affordable Care Act will have to begin paying part of the associated costs, and three of the Midwest’s expansion states say they will rely at least in part on revenue from their taxes on health care providers.
State constitutions were changed and policies on issues ranging from medical marijuana to the death penalty were decided on by voters across the Midwest this November.
In all, 20 ballot proposals were voted on in seven states in the region. Here is a review of some of the proposals that won voter approval.
With the pending shift in partisan control of the Iowa and Minnesota senates to the Republican Party, nearly every legislature and governor’s office in the 11-state Midwest will be led by the GOP over the next two years.
Power will be divided among the parties in only two of the region’s states: Illinois, Republican governor and Democratic legislature; and Minnesota, Democratic governor and Republican legislature. (Nebraska’s Unicameral Legislature is nonpartisan.)
Michigan and Ohio have been recognized as national leaders in how they employ technology to improve state government operations and services. Released in September, the biennial “Digital States Survey 2016” graded all 50 states on criteria that ranged from cost savings to improved service delivery.
For patients who develop sepsis, the ability of a health professional to recognize it early on can mean the difference between life and death, or between full recovery and permanent organ damage. For doctors and nurses, though, early recognition of this condition (caused by the human body’s response to an infection) can be difficult.
“The symptoms are like those for the flu and many other diseases,” says Kelly Court, chief quality officer at the Wisconsin Hospital Association. “So you need to get the entire clinical team at a hospital to think sepsis when evaluating a patient, because early detection is so important.”
Four years ago, that early detection did not take place in a case that led to the tragic death of a 5-year-old girl in Illinois. The girl, Gabby Galbo, died from sepsis after a tick bite caused a bacterial infection.
Gabby’s Law (SB 2403), signed into law this summer after receiving unanimous legislative approval, puts in place new statewide requirements for hospitals, which will now have to establish and then periodically implement evidence-based sepsis protocols — for example, a process for screening and early recognition, identification of the infectious source, and guidelines for how to administer fluids and deliver antibiotics to patients. Direct-care staff in Illinois’ hospitals will have to receive periodic training on these protocols.
In early 2012, a 17-year-old stood up in a high school cafeteria in northeast Ohio and began shooting. Three students died, three were injured. For the leaders of Ohio’s systems of mental health and developmental disabilities, that tragic incident became a call to action.
“After the fact, people said, ‘We had seen signs,’ but nobody knew what to do or how to connect with resources,” notes Tracy Plouck, director of the Ohio Department of Mental Health and Addiction Services.
What could the state do to help fill those resource gaps? How could it assist families and communities wanting to help a troubled young person? In part, the response has been the creation of Strong Families, Safe Communities, the goal of which is to improve care coordination and crisis-intervention services for individuals between the ages of 8 and 24 at risk of harming themselves or others due to a mental illness or developmental disability.
One long-standing, widespread state strategy to collect debt has been the use of offset programs — ensuring that any pending payments to individuals or entities (tax refunds, for example) are used to cover their delinquent obligations.
In fiscal year 2015, for example,Iowa’s Offset Program collected $47.2 million in debt, a 162 percent increase from FY 2006. Two primary factors have contributed to this increase in debt recovery. First, certain casino winnings must now be used to pay an individual’s debt. (Other offsets can come from tax refunds, lottery winnings, and payments to vendors for goods and services.) Second, Iowa allows local governments to participate in the program. This local involvement also takes place in states such as Kansas, Minnesota and Wisconsin.