Through a COVID Lens: Top Legislative Issues of 2021.

• Author: Winter, Mary

State legislators constantly address challenging issues. For the last 10 months, though, they've found themselves in a war with a crisis that affects nearly every policy issue and has jolted the economy.

As the new year began, COVID-19 had claimed the lives of more than 350,000 Americans and infected millions more. Tens of thousands of businesses had closed or were struggling. Millions of students were adjusting to learning remotely, and the doctors, nurses and other health care workers on the front lines were exhausted. Bringing the still-raging virus to heel will consume lawmakers' attention, as all states and territories convene sessions this year.

"COVID will change everything," says Connecticut House Speaker Matt Ritter (D). "I can't imagine we won't look at most bills through the COVID lens."

COVID will change everything. I can't imagine we won't look at most bills through the COVID lens.--Connecticut House Speaker Matt Ritter Before lawmakers could begin the difficult deliberations that awaited them this year, they had to figure out how to conduct business safely. Most states and territories held special sessions, interim hearings or meetings in the summer and fall to collect information and weigh options. Many are using lessons learned in 2020.

"This COVID situation may limit us in what we can or cannot do," Kentucky Senate President Robert Stivers (R) says. "So, (this year) the process may be a bigger story than the policy that we deal with."

The biggest issues of any year are often the same every year. But 2020 was not just any year, and COVID-19 is not just any virus. Here is a look at what to expect in 2021 sessions.

Fighting the Virus

State lawmakers are not only grappling with the effects of the virus but also battling the disease itself--providing public health and health care workers what they need to prevent its spread and stay safe.

Each state has developed a plan that ensures adequate testing supplies, timely test results and ample testing opportunities for underserved populations. States have expanded laboratories, partnered with academic, federal and private organizations, and scaled up drive-through testing sites, among other strategies.

And now states are focusing on distributing, allocating, storing and administering the vaccines as they become available. Several states are modifying their scope-of-practice laws for certain health care providers, including pharmacists, pharmacy technicians and dentists, to increase the number of professionals available to administer vaccines.

More than 40 states temporarily modified licensing requirements to recruit more health care workers. Vermont, for example, relaxed requirements for retired and out-of-state health professionals, and Kentucky passed a bill allowing medical students to conduct triage and diagnose and treat patients if under fully accredited supervision.

Several legislatures passed bills that establish, coordinate or fund contact tracing. In Rhode Island, businesses must cooperate on testing, contact tracing and disease investigation before they are allowed to reopen from lockdown.

In Kansas, concerns over potential privacy violations persuaded lawmakers to put a hold on the use of tracking technology until April, to give the legislature time for a more thorough review of how it should be regulated.

A Kaiser Family Foundation survey last July showed 53% of adults (up from 32% in March) reported that COVID-19-related stress had negatively affected their mental health, leading to increases in substance abuse, domestic violence and thoughts of suicide. The combination of social isolation and loneliness, economic stress, lack of mental health treatment and widespread national anxiety has created what the journal JAMA Psychiatry refers to as "a perfect storm" for suicide.

To tackle this growing mental health problem, the Minnesota Legislature targeted rural areas with suicide prevention training and increased mental health awareness training for young people. The Alabama Legislaturegave county and regional mental health centers a $2.5 million boost. Colorado used federal CARES Act money to continue operating its crisis hotline, and Utah built on previous legislative successes by expanding services available through its hotline.

Plugging Budget Gaps

A top priority of every legislative session is passing a balanced budget. That will be especially challenging in some states where the economy continues to sputter and revenues continue to stagnate.

Revenue projections have varied greatly since the start of the pandemic. Many states projected dire losses early on, but midway through the fiscal year, some have seen state tax revenues higher than original projections. A handful of states, including Idaho and South Dakota, have experienced revenues greater than even pre-pandemic estimates. However, most states still anticipate challenging budget discussions ahead.

Kentucky...