Building the System: Follow-up, monitoring & adaptive management

Does impact assessment (IA) end when the license has been granted? While societal resources tend to focus on rigorous project approvals, what happens to the project, to the public and to the environment once approval is granted? Follow up and monitoring are often an afterthought for legislators, public servants and proponents. But they are critical to public confidence and to ensuring that proponents live up to their commitments in a rapidly changing world."This report draws from research funded by the Impact Assessment Agency as part of the Social Sciences and Humanities Research Council of Canada Knowledge Mobilization Grant on Informing Best Practice in Environmental and Impact Assessment.

Preparing for Climate Impacts: Lessons from the Front Lines

In a synthesis report to The Kresge Foundation, the Georgetown Climate Center shares lessons learned from its adaptation work in recent years. The report includes short case studies highlighting successful efforts as well as barriers to change

Encouraging Integrated Care for Dual Eligibles

Outlines examples and elements of integrated care models for those eligible for both Medicare and Medicaid, including multidisciplinary care teams, comprehensive provider networks, and data sharing, that would eliminate inefficiencies and reduce costs

The State of Adaptation in the United States: An Overview

Over the past two decades the adaptation landscape has changed dramatically. From its early days as a vague theoretical concept, which was often viewed as a threat to advocating for the reduction of greenhouse gas emissions, it has developed into a widely, albeit not universally, recognized governmental mandate to reduce societal vulnerability to climate change. While it is important to appreciate the progress that we are making on this issue, it is impossible to ignore the urgent need to do more. Smart investment can be made by reflecting on what is already underway in order to determine where to build on existing efforts and where to innovate new approaches to fill the gaps in the path forward. In this report we provide illustrative examples of the variety of work on climate change adaptation that is underway in the United States. This is by no means an exhaustive survey of the field; however it does provide insight into the dominant focus of work to date, the resultant gaps, and the opportunities available for advancing this essential aspect of sustainability. We focus on four areas of activity -- agriculture, natural resources, human communities, and policy. The general trends relevant to these sectors can be applied more broadly to other sectors and countries. Adaptation can be thought of as a cycle of activities that ultimately -- if successful -- reduces vulnerability to climate change. This process starts with identifying the impacts of climate change to determine the types of problems climate change might pose. This includes all of the research on the causes and the global, regional, and local manifestations of climate change, often referred to as impacts assessments

Harmonizing Climate Change Mitigation and Adaptation in Transportation and Land-Use Planning in California Cities

Abstract: Recent extreme weather events in California—wildfires, drought, and flooding—make abundantly clear the need to plan effective responses to both the causes and the consequences of climate change. A central challenge for climate planning efforts has been identifying transportation and land-use (TLU) strategies that simultaneously reduce greenhouse gas emissions (“mitigation”) and adapt communities so that they will be less affected by the adverse impacts of climate change (“adaptation”). Sets of policies that collectively address both mitigation and adaptation are known as “integrated actions.” This study explores municipal climate planning in California to determine whether cities incorporate integrated actions into their plans, assess the potential drivers of conflict between mitigation and adaptation in municipal plans, and identify ways the State of California can help cities more effectively incorporate integrated actions. The study methods consisted of a detailed analysis of climate planning documents from 23 California cities with particularly long histories of climate planning, plus interviews with 25 local, regional, and state officials who work on municipal climate planning. The authors found that some cities did adopt packages of integrated actions, and, promisingly, two cities with recently updated climate plans explicitly focused on the need for integrated actions. However, most cities addressed climate mitigation and adaptation in separate efforts, potentially reducing synergies between the two types of action and even creating conflicts. Since the first generation of climate action plans focused primarily on mitigation of greenhouse gases (GHGs), adaptation strategies have not yet been effectively or fully combined into mitigation plans in many cities. Also, a cross-comparison of plan content and interview data suggests that cities often had sets of policies that could potentially create conflicts—mitigation policies that would undermine adaptation capacity, and vice versa. In addition, where a city did adopt integrated actions, these efforts are typically not labeled as such, nor do the policies appear within the same policy document. The study findings suggest promising steps that both municipal and state governments can take to support integrated TLU actions at the local level. For example, cities can proactively link the content in climate mitigation and adaptation plans—a process that will require building the capacity for cross-collaboration between the various departments in charge of developing, implementing, and monitoring climate-related plans. As for the state government, it can provide funding specifically for planning and implementing integrated actions, offer technical support to help municipalities adopt programs and projects that produce integrated mitigation and adaptation benefits, and fund research in the area of integrated actions

External Program Evaluation: Water, Sanitation and Hygiene (WASH) Program in Ethiopia

USAID/Ethiopia commissioned this study to evaluate an ongoing Millennium Water Alliance (MWA) program and to generate findings that could assist in developing monitoring and evaluation indicators for future use. As of 2008, MWA was implementing eight WASH projects in 28 districts, with stated goals of improving access to sustainable and adequate water, improving access to sanitation services, increasing community awareness, and promoting safe hygiene practices. The evaluation calls MWA's progress encouraging overall, but notes that the one to two year planning horizons used were not enough to cause internalized behavior change. Furthermore, the authors recommend investing more in research and development; adopting harmonized approaches and best practices as well as innovative methodologies; building capacity of district water, health, and education offices; and linking the MWA program with other government, USAID, WSP and UNICEF programs

Strengthening America's Best Idea: An Independent Review of the National Park Service's Natural Resource Stewardship and Science Directorate

NRSS requested that an independent panel of the National Academy conduct a review of its effectiveness in five core functions, its relationships with key internal stakeholders, and its performance measurement system. Among other things, the National Park Service's Natural Resource Stewardship and Science Directorate (NRSS) is responsible for providing usable natural and social science information throughout the National Park Service (NPS). NRSS leadership requested this review of the directorate's performance on five core functions, its relationships with key internal NPS stakeholders, and its performance measurement system.Main FindingsThe panel determined that NRSS is a highly regarded organization that provides independent, credible scientific expertise and technical information. The panel also found that NRSS and NPS have additional opportunities to advance natural resource stewardship throughout the Service. If implemented, the panel's eight major recommendations will: (1) help the Service respond to the parks' environmental challenges while raising public awareness about the condition of these special places; (2) strengthen NRSS as an organization; (3) promote scientifically based decision-making at the national, regional, and park levels; and (4) improve the existing performance measurement system

N.C. Medicaid Reform: A Bipartisan Path Forward

The North Carolina Medicaid program currently constitutes 32% of the state budget and provides insurance coverage to 18% of the state’s population. At the same time, 13% of North Carolinians remain uninsured, and even among the insured, significant health disparities persist across income, geography, education, and race. The Duke University Bass Connections Medicaid Reform project gathered to consider how North Carolina could use its limited Medicaid dollars more effectively to reduce the incidence of poor health, improve access to healthcare, and reduce budgetary pressures on the state’s taxpayers. This report is submitted to North Carolina’s policymakers and citizens. It assesses the current Medicaid landscape in North Carolina, and it offers recommendations to North Carolina policymakers concerning: (1) the construction of Medicaid Managed Care markets, (2) the potential and dangers of instituting consumer-driven financial incentives in Medicaid benefits, (3) special hotspotting strategies to address the needs and escalating costs of Medicaid\u27s high-utilizers and dual-eligibles, (4) the emerging benefits of pursuing telemedicine and associated reforms to reimbursement, regulation, and Graduate Medical Education programs that could fuel telemedicine solutions to improve access and delivery. The NC Medicaid Reform Advisory Team includes: Deanna Befus, Duke School of Nursing, PhD ‘17Madhulika Vulimiri, Duke Sanford School of Public Policy, MPP ‘18Patrick O’Shea, UNC School of Medicine/Fuqua School of Business, MD/MBA \u2717Shanna Rifkin, Duke Law School, JD ‘17Trey Sinyard, Duke School of Medicine/Fuqua School of Business, MD/MBA \u2717Brandon Yan, Duke Public Policy, BA \u2718Brooke Bekoff, UNC Political Science, BA \u2719Graeme Peterson, Duke Public Policy, BA ‘17Haley Hedrick, Duke Psychology, BS ‘19Jackie Lin, Duke Biology, BS \u2718Kushal Kadakia, Duke Biology and Public Policy, BS ‘19Leah Yao, Duke Psychology, BS ‘19Shivani Shah, Duke Biology and Public Policy, BS ‘18Sonia Hernandez, Duke Economics, BS \u2719Riley Herrmann, Duke Public Policy, BA \u271