State/Provincial Update - October 26, 2016

Registration is Open for GFOA's 2017 Annual Conference

GFOA’s 111th Annual Conference will take place May 21─24, 2017, at the Colorado Convention Center in Denver, Colorado. Go to the “Annual Conference” tab on GFOA’s website to access the conference brochure and registration form, sign up for preconference seminars, reserve your room in GFOA’s official hotel block, and sign up for tours.

We will hold the rate of $380 for all GFOA state and provincial representatives and presidents through the span of the conference. 

If you are a GFOA active government member who has never attended the annual conference, we invite you to apply for a first-time annual conference attendee scholarship. Fifty scholarships will be awarded per state or province in the amount of the full-conference registration fee. To learn more about this opportunity and to apply, e-mail First Annual Conference.

We are still accepting speaker and topic suggestions for the annual conference. Click here to submit your recommendation. Full program session details will be announced in January 2017. If you have any questions about the annual conference, contact GFOA.


Don’t Miss This Year’s GAAP Update!

There’s still time to host your members for the 21st Annual Governmental GAAP Update web-stream event on November 3 from 1:00 p.m. to 5:00 p.m. (Eastern). Take advantage of group discounts on the registration fee.

Learn everything you need to know about the most recent developments in accounting and financial reporting for state and local governments, including the latest GASB statements, exposure drafts, and implementation guidance. Click here for details and to register today!

If you have any questions about the training, contact GFOA


Sign up as a Host Viewing Site

There are no direct costs to your organization for hosting a viewing site. Out-of-pocket expenses, such as facility and/or equipment rental or food/refreshments will not be reimbursed, however. To help offset these costs, GFOA offers a revenue sharing program, through which organizations will earn a percentage of their site’s net revenue based on the total number of paid participants. The program is open to state associations and government entities, but is not open to private-sector organizations. To sign up as a host viewing site, contact Barb Mollo.

An encore presentation of the GAAP Update will take place on 
 December 1. The early discount registration fee for the December 
 offering ends November 8.


Help us Spread the Word about GFOA’s Upcoming In-Person Training Courses

Take advantage of meeting colleagues face-to-face in your home state or surrounding area during GFOA’s group-live courses. Training courses are presented at basic, intermediate, or advanced levels.

  • Chicago, Illinois: November 14─18, 2016
  • Austin, Texas: December 5─9, 2016
  • Long Beach, California: January 23─27, 2017
  • New Orleans, Louisiana: February 13─17, 2017
  • Reno, Nevada: March 20─23, 2017
  • Chicago, Illinois: March 27─31, 2017 (Accounting Academy)
  • Portland, Oregon: April 3─7, 2017
  • Newport Beach, California: April 25─28, 2017 (Budget Academy)

Go to GFOA’s training schedule page to view course details and to read about future training announcements. Click here to access a registration form and to read about available discounts. Click here to access information about hotels and rates.

If you have any questions about the training, contact GFOA.


What Drives Rising Health-Care Costs? Part 2

Government leaders across the United States are concerned with rising health-care costs – but what are the root causes of those large and persistent annual increases that we all have learned to take for granted? Understanding those forces will inform the strategies your organization needs to contain the cost of employer-provided health benefits.

Advances in Medical Technology

In 2008, Congressional Budget Office (CBO) testimony pointed to advances in medical technologies as a primary driver of increasing health-care costs. Advances in medical technology are obviously important, but there is no requirement that effectiveness be demonstrated before a technology is adopted in the U.S. health-care market. This may be due in part to a large appetite for innovation among U.S. health-care consumers. Eagerness for innovation, however, seems to have created a culture where medical technologies are adopted prematurely and new medical technology is employed for additional uses beyond the original intent. In some instances, technologies that offer only marginal improvements over existing treatments—but with dramatically higher price tags – are adopted broadly and rapidly.

The average patient wants the most modern care available, often regardless of price. This creates an inherent problem from a cost-control perspective because people usually view their health as their most valuable asset. Complicating the matter further is that the consumers setting the “far-market value” for such advances in medical technology (by being willing to pay for them) often aren’t willing to bear the full cost burden. Purchasers do not typically pay for the services they consume at the time of consumption. Payment for care is almost exclusively a function of insurance companies, with the consumers paying a fraction of the actual cost in the form of a co-payment. This would distort the value assignment in a buying transaction under any circumstances, but when a patient’s health is in jeopardy, he or she is more motivated than usual to make the purchase (i.e., procure treatment), leading patients to seek advanced treatments or technology. An approach that could help here is evidence-based medicine, which was pioneered by Oxford University with the goal of going beyond empirical “support” to encourage the use of only the strongest types of empirical “evidence” such as meta-analyses, systematic reviews, and randomized control trials for medical treatment recommendations.

Aging Workforce

Workers who are 55 or older will likely make up approximately 26 percent of the labor force by 2022, compared to 21 percent in 2012 and just 14 percent in 2002, according to the Bureau of Labor Statistics. This aging population is expected to play a large role in the increased cost of Medicare, Medicaid, and health care generally over the next 25 years. As this generation ages, more people will require increased levels of care, creating more demand. When demand increases, suppliers can usually charge more, further driving up costs. In this case, wellness clinics may be able to reduce the likelihood of catastrophic medical events through early detection and increased preventative care.

Unhealthy Lifestyles

Increases in addictions, obesity rates, and inactivity are all linked to chronic health conditions that cause some of the heaviest use of medical services. Chronic diseases are the most common and costly of all health problems, but they are also the most preventable. People who have three or more chronic diseases fall into the top 1 percent of patients who account for 20 percent of all health care spending in the United States. The extent to which an employer endorses health improvement initiatives can play a significant role in an employee’s lifestyle choices. Employers can make a difference here by supporting healthy lifestyles among employees; one strategy is implementing a formal wellness program.

If employer support can truly reduce addiction, obesity, or inactivity, then it would seem reasonable to assume that doing so might lead to a reduction in the medical costs associated with these conditions. One approach to curbing unhealthy behavior is an addiction (e.g., tobacco) cessation program, coupled with cost-sharing programs like HDHPs. Still, simply offering incentives or passing costs along to employees is not sufficient. Studies on monetary incentives for smoking cessation demonstrate that a one-dimensional approach can fall short. This is because without multidimensional and sustained involvement from the employer, employees typically relapse shortly after the incentive ends. On the other hand, multidimensional approaches such as wellness programs and onsite clinics, coupled with incentives or cost-sharing, yield sustained results.

Part 3 of this article, in next month’s newsletter, will discuss the roles of high administrative costs and the consolidation of service providers.

If you have any questions about this article, please contact Mark Mack, a consultant in GFOA’s Research and Consulting Center.


Certified Public Finance Officers (CPFO) Program Testing this Fall

The CPFO Program of GFOA is a broad educational self-study program designed to verify knowledge in the disciplines of government finance. To earn the CPFO designation, candidates must pass a series of five examinations covering the major disciplines of public finance. 

The CPFO exams are taking place this Fall at locations across the U.S. Click here for more information about the exams and the Certification Program.

To date, there are 664 individuals who have achieved the CPFO designation. Click here for a listing of all active CPFOs that is searchable by state. If you have any questions about the CPFO Program, contact Jim Phillips, Senior Program Manager.


GFOA Awards Program Update

GFOA encourages and recognizes excellence in financial reporting, budgeting, and financial management by granting awards to those governments that meet program standards. Below are the latest recipients of Program awards:

  • Certificate of Achievement for Excellence in Financial Reporting Program (CAFR Program)

The due date to submit the June 30, 2016, fiscal-year ended reports to the CAFR Program is December 31, 2016. Extensions are available if you are not able to meet the submission deadline. You can request an extension by e-mailing

Click here if you are interested in participating in the CAFR Program or serving as a reviewer. 

  • GFOA’s Latest Budget Awards Program Winners

GFOA has just completed its list of the most recent winners of its Distinguished Budget Presentation Award. One thousand, five hundred sixty-five governments have received the award for the budget year that began January 1, 2015. Click here to see the names of the governments and to access PDFs of their award-winning budget documents. In addition, the 2016 award winners (through September 30, 2016) have been posted.

If you have any questions regarding the award winners, please contact Kathie Schultz, Senior Program Associate, GFOA Technical Services Center.

  • Popular Annual Financial Reporting (PAFR) Award Program First-Time Winners

Congratulations to the following governments for achieving the PAFR Award for the first time:

          • Citrus County, Florida

          • Indian River County, Florida

Read more about the PAFR Program or e-mail us if you have any questions.


Do you have an Upcoming Annual Conference?

If so, please fill out the “GFOA Promotional Items” form, checking off any materials you are interested in receiving for your upcoming annual conference. The form is interactive, so you can type and save your changes directly to the document. Submit the completed form at least two months before your event to Kate Southard. Please note: raffle items are limited to annual conferences.

If your state or provincial association has any new educational or mentor programs to promote or events at your annual conference to connect fellow finance officers and advance the profession, we will share the information in this monthly memorandum. Please send a brief description of your program to Natalie Laudadio.


Washington Update

Click here for the latest Washington Update prepared by our Federal Liaison Center in Washington, DC. More information may also be found on the Federal Government Relations section of GFOA’s website.


Help Us Keep Our State/Provincial Officer Directory Up-To-Date

If you have not done so yet, please review the State/Provincial Officer Directory we have on file and let us know if you have any changes. Any changes can be emailed to Kate Southard.