Sanford School of Public Policy

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The two-year professional MPP program prepares students for leadership roles in various levels of government, non-profit organizations and with corporations both in domestic and international locations. Dual degrees with Duke or UNC schools are available in law (JD) and business (MBA) at the University of North Carolina at Chapel Hill, and environment (MEM) at North Carolina State University. A dual degree in medicine (MD) is available with Duke's Medical program. The MPP program requires fulltime enrollment and most students possess two to six years of post-undergraduate work experience.

The Master's Project (MP) is a 20-30 page single-spaced paper required of all master's students in public policy. Two types of projects are possible: a project for an actual client that involves a variety of methodological approaches, or a project based on quantitative methods that may or may not have an actual client. A client-based project addresses a policy problem and recommends a specific course of action to resolve it. The project must also measure up to the standards of good analysis, including precise definition of the problem, assemblage and careful evaluation of the relevant evidence, identification of important trade-offs, and clear presentation of the conclusions and recommendations. A quantitative MP focuses on assembling and analyzing data to address a question of relevance to a substantive area of policy. The quantitative project puts more emphasis on the quality and interpretation of the data analysis than on the broader range of political and ethical issues that arise in making specific policy recommendations. Students are encouraged to build their projects from their summer internships where possible and to deepen their policy-area expertise by taking appropriate elective courses.

Duke migrated to an electronic-only system for masters projects between 2006 and 2010. As such, projects completed between 2006 and 2010 may not be part of this system, and those completed before 2006 are not hosted here except for a small number that have been digitized.


Recent Submissions

Now showing 1 - 20 of 274
  • ItemOpen Access
    Best Practices for Modernizing Integrated Public Benefits Applications
    (2023-04-19) Holtzman, Rachel
    Many state agencies around the country are trying to modernize applications for public benefits programs in their state. This work often involves developing an integrated application for two or more public benefits, and then engineering an online portal on which to host the integrated application. Because most state agencies lack the technological expertise to do this work in-house, they hire third party vendors and consulting firms to help. This report thus seeks to answer the question: What can be learned about best practices for equitable applications, from states that have modernized their remote integrated benefits applications for Medicaid, Supplemental Nutrition Assistance Program (SNAP) and/or Temporary Assistance for Needy Families (TANF) programs since the Affordable Care Act? To answer this question, the researcher conducted 24 interviews with Subject Matter Experts involved in designing, building, launching, administering, and/or researching integrated benefits applications. Findings include best practices for the processes of hiring, building, launching, and conducting outreach related to integrated benefits applications. States must also ensure that the benefits applications are human-centered, meaning that the features and capabilities of the application facilitate equitable access and successful enrollment by applicants with diverse backgrounds, identities, and needs.
  • ItemOpen Access
    Rectifying Racial Wealth Disparities through Baby Bonds
    (2023-04-26) Roberts, Xavier
    This paper proposes recommendations for the design of a Baby Bonds pilot program by the GRO Fund, with the aim of reducing racial wealth inequality and promoting economic empowerment among minoritized populations. Drawing on the history of the racial wealth gap and insights from publications and interviews, the paper proposes specific recommendations for the GRO Fund's program design. To assess various aspects of Baby Bonds’ impact, the GRO Fund should consider a program duration of 10+ years with two cohorts of different ages and interim data gathering. Eligibility requirements can be based on participation in existing programs and/or household income. This paper discusses three levels of race specificity - race-neutral, race-conscious, and race-specific - and recommends that the GRO Fund aims to be race-specific. Usage restrictions should mimic archetypal Baby Bonds but consider additional wealth-building strategies. Drawdown restrictions should block fund access until participants are 18 years of age, with limited access before 18 in emergency circumstances. Financial advising should be offered to recipients instead of financial literacy training to better support their financial well-being. Lastly, this paper recommends that the GRO Fund invests funds in an investment vehicle that minimizes risk to principal, earns 4-6 percent annual interest, and is easily liquidated. These recommendations attempt to take into consideration the unique needs and goals of the GRO Fund and its target communities, while also aligning with the core principles of Baby Bonds. The implementation of a well-designed Baby Bonds pilot program by the GRO Fund has the potential to significantly contribute to reducing racial wealth inequality and promote economic stability among minoritized populations by furthering the case for Baby Bonds.
  • ItemOpen Access
    Guaranteed Income in Durham, NC: Political Feasibility Prospective
    (2023-04-28) Stamper, Zach
    Child economic insecurity continues to be a prevalent issue in the United States, and in Durham, NC. Grown in Durham (GiD), the childcare initiative spawned from Durham County’s Early Childhood Action Plan, seeks to address this issue. GiD used a community-based approach to determine its priorities by including local parents and childcare experts in the planning process. One of the top priorities identified was a guaranteed income pilot program to provide supplemental cash assistance to Durham families facing economic insecurity. This policy solution was chosen because of the versatility of cash benefits and positive outcomes from other guaranteed income pilots across the country, including one already conducted in Durham. Given these pilot program successes, GiD anticipates their own guaranteed income pilot would have similarly positive outcomes. Thinking ahead of pilot success, this descriptive study seeks to understand the future of guaranteed income efforts in Durham. GiD asks “what is the political feasibility of a city or county-wide guaranteed income program serving families with children facing economic insecurity in Durham, NC?” Literature review of large-scale guaranteed income efforts, interviews with local elected officials and subject matter experts, and stakeholder analysis of local municipal government systems provide insights for this policy question. The multiple streams framework is employed to determine political feasibility as a function of cohesion in understanding of the problem of child economic insecurity and the policy of guaranteed income as a solution in the context of Durham politics. Review of relevant literature illuminated guaranteed income pilot program success in generating positive outcomes for participants facing economic insecurity and analyzed examples of similar policies that have been implemented at the state and national level. Regardless of overwhelmingly positive outcomes, individual support for guaranteed income and other social service provisions is ultimately dependent on one’s values, particularly the role of work in determining deservingness of support, and acknowledgment of systemic factors. These values do not exclusively fall along partisan lines, affording a more nuanced analysis of guaranteed income support. Policies closely resembling guaranteed income employed by Alaska, a traditionally conservative state, and at the national level demonstrate this nuance. Local elected officials and guaranteed income subject matter experts were interviewed to gauge the political feasibility of a scaled guaranteed income program in Durham. Elected officials included city council members and county commissioners, and subject matter experts included administrators of guaranteed income pilot (and related) policies in Durham. An interview guide was developed to gather data in the multiple streams framework and facilitate further conversation about anything that may dictate guaranteed income’s political feasibility in Durham. Interviews revealed the perception of a high amount of guaranteed income support from both Durham’s elected officials and general public. Interviews indicated a general consensus around the understanding of the problem of child economic insecurity, guaranteed income as a policy solution, and elected official and public support of such a policy. This stream alignment is encouraging for political feasibility. Funding was identified as the main logistical roadblock in implementing a city or county-wide guaranteed income for families with children experiencing economic insecurity. Municipal funding restrictions would need to be addressed to utilize this funding source at this crucial stage between pilot success and scaling beyond the municipal level by utilizing state or federal funding. A local stakeholder analysis provides political system context through which a municipally funded guaranteed income policy would have to pass. Interview respondents also corroborated the significance of personal values in dictating guaranteed income support. Interview and literature review insights prompted the following recommendations for GiD to implement to sustain guaranteed income’s political feasibility into the future: • Advocating for the resolution of municipal funding restrictions. • Developing clear and inclusive communication about what guaranteed income is, how it addresses economic insecurity, who it benefits, and destigmatizing welfare recipients. • Intentionally maintaining momentum around guaranteed income as a policy solution (e.g., strengthening a local advocate network, periodic communications, and informational programming). The future of guaranteed income in Durham is bright, and GiD can hold the light to lead the way.
  • ItemOpen Access
  • ItemOpen Access
    Smart Microgrids to Improve Reliability and Resiliency of Power Supply in the Southeast
    (2023-05-01) Pumarejo Villarreal, Jose Eduardo (Puma)
    Extreme weather events in the Southeast have frequently caused significant damage to the power grid, leaving millions without electricity for extended periods. Despite substantial investments, vulnerabilities stemming from the centralized nature of the system remain unresolved. However, the implementation of decentralized smart microgrid technology presents a potential solution to mitigate the impacts of extreme weather events and enhance power supply reliability and resiliency. Microgrids, which consist of interconnected loads and distributed energy resources, can operate in coordination with the main grid or independently. Each microgrid requires a customized approach to design, installation, and management. Although smart microgrids can improve power supply reliability and resiliency by up to 60%, their high costs often render projects financially unfeasible. To accelerate the adoption of microgrids in the Southeast, clear state-level regulations, standardized guidelines for electric utilities, and economic assessments of resilient infrastructure are needed. Additionally, exploring the establishment of a Southeast ISO could facilitate the replication of successful practices from regions like California, Texas, and New York.
  • ItemOpen Access
    Supporting Women Vanilla Farmers in Madagascar: The Promise of VSLAs and Alternative Livelihoods
    (2023-05-10) Poulos, Margaret
    To examine how to strengthen the income security and overall resilience of women vanilla farmers, I ask: How can Duke Lemur Center (DLC)-SAVA Conservation better support the livelihoods of local women vanilla farmers in Ambodivoara, Madagascar, through training in alternative livelihoods? What is the economic, social, and environmental potential for the establishment of village savings and loans associations (VSLAs) for women vanilla farmers? Drawing from three months of field research in Madagascar, I offer policy recommendations to answer these questions.
  • ItemOpen Access
    Economic Trends Affecting National Discourse
    (2023-04-19) Schaffernoth, Charles Adam
    Topic: How has the evolution of advertising technology, and its economic repercussions, contributed to the concentration and polarization of America’s traditional media ecosystem and national discourse? What potential policy options can most effectively address the root causes of this trend? Abstract: This analysis strove to demonstrate that the polarization currently afflicting American national discourse is partially structural in nature, and that this structural component can be primarily attributed to the major stakeholder groups’ competitive responses to disruptive technological innovation and its economic repercussions. Furthermore, the paper illustrates the tangible and material harms caused by growing polarization and offers policy solutions that apply to each of the main stakeholder groups involved in the complex system embodied by the nation’s social and political debate. Interestingly, this paper concurred with Mark Twain’s observation that “history doesn’t repeat itself, but it often rhymes,” in that the dated practice of yellow journalism in news media, the recurrent strategy of emulating competitors’ tactics in business, and the contemporary rediscovery of narrowcasting as a tool for customer segmentation online, have all reemerged as themes in the internet era’s fractured information landscape.
  • ItemOpen Access
    (2023-04-20) Butler, Antonio
    The baby formula shortage was a challenging experience for everyone in the U.S., yet low-income mothers experienced the worst effects of the baby formula shortage. Through conducting virtual interviews of mothers, I built a theory that uncovered three themes and multiple sub-themes that emerged on how low-income mothers coped with the baby formula shortage. These three themes were: (1) Access to and availability of baby formula during the shortage was difficult. (2) Community support in obtaining baby formula played a prominent role in mother's lives. (3) Social services and the healthcare system, specifically doctors, played a significant role in alleviating the baby formula shortage for mothers. Alongside these interviews, a background analysis of the policy and cultural situations was reviewed to provide context on how a baby formula shortage came to be. The background information provided along with the interviews resulted in the creation of policy implications and recommendations ranging from policymakers changing requirements around WIC to social service officers partnering more with community organizations. These two pieces of information undergird this master's project (MP), which is meant to help guide policymakers and social service officers on how to best support low-income mothers and mothers writ large during their potential baby formula purchasing experience. By learning from their experiences and implementing recommendations that tackle the breadth and depth of the issues that caused the baby formula shortage, we can ensure we are effectively supporting two populations that are extremely important to the current and future success of our communities and the U.S., mothers, and infants.
  • ItemOpen Access
    Reporting the Shots: Exploring Barriers and Facilitators in Pediatric Vaccine Reporting
    (2023-04-19) Israelsen-Hartley, Sara
    For 30 years, the Vaccines for Children (VFC) Program has ensured low-income children have access to vaccines, leading to millions of illnesses averted, hundreds of thousands of deaths avoided and billions of dollars in health savings. Yet policy, technology and personnel gaps allow many VFC vaccines to remain unreported to a jurisdiction’s immunization information system (IIS). This study identified potential barriers and facilitators to IIS reporting among VFC providers through in-depth, qualitative interviews with pediatric healthcare workers across four reporting-mandated, but historically under-reporting states: Colorado, Connecticut, Maryland, and Massachusetts. The study also highlighted COVID-19 influences on provider IIS reporting.
  • ItemOpen Access
    A Background and Case Study on Septic Tank Failure as it Relates to Climate Impacts, Recent Climate Policy, and Community Needs
    (2023-04-28) Oglesby, Cameron
    In the two years since President Joe Biden took office there has been an unprecedented national focus on environmental justice and climate justice in the distribution of federal funds and resources. There has also been an influx of federal funds made available to address a pervasive history of infrastructure disinvestment across the country, particularly water and wastewater infrastructure. This report attempts to converge the issues surrounding waste management infrastructure in the U.S., specifically regarding septic system failure, and the opportunity areas for improvement in federal dollars, outlining the policy history, modern context, and recommendations for taking advantage of this current moment of public salience. This report outlines a thorough national policy history for septic system infrastructure as well as recent policy opportunities and community concerns regarding federal funds. This report also attempts to outline the greatest indicators or identifiers for septic failure as well as breakdown potential policy solutions or priority areas for federal and state-level actors and advocates based on septic and sewer infrastructure investments taking placed in Miami-Dade County in Florida and the Middle Peninsula/Chesapeake Bay region of Virginia. The background and case study analysis consists of a literature review of national and regional septic failure, utilizing what little academic literature exists on the topic and more recent journalistic coverage of this issue across the U.S. The national background as well as individual case studies are further fleshed out through a series of interviews with academic and community experts in water protection and wastewater management. The final product is a comprehensive overview of septic system policy history, modern funding opportunities, and solutions/recommendations based on expert testimony.
  • ItemOpen Access
    $100 Million Dollars Later: Are School Resource Officers Making North Carolina Schools Safer?
    (2023-04-20) LeFebvre, Joanna
    Since 2016, North Carolina has spent over $100 million on School Resource Officer (SRO) salaries and training. Research consistently finds SROs have little to no effect on school safety and can contribute to over-disciplining students. A difference-in-differences study on the effect of a 170% increase in SRO funding for North Carolina elementary and middle schools in 2018 suggests SROs have no effect on criminal acts or short-term suspensions but may increase the number of school-related arrests. Estimates suggest SROs caused an increase of about 0.035 arrests (p<0.1) per 1,000 elementary and middle school students. This translates to an additional 35 school-related arrests resulting from SRO presence. Arrests of students with disabilities increased by 0.243 (p<0.1) per 1,000 students, arrests of male students increased by 0.058 (p<0.1) per 1,000 students, and arrests of economically disadvantaged students increased by 0.068 (p<0.1) per 1,000 students. Findings for these subgroups align with previous research suggesting these students are particularly vulnerable to excessive disciplining. Lawmakers should consider these results when deciding the best ways to increase student safety and well-being in elementary and middle schools. Additionally, the state should require school districts to collect SRO data at the school level to evaluate the effects of SROs across time and decide if this investment of taxpayer dollars produces the desired results.
  • ItemOpen Access
    Maximizing Impact: Attracting and Prioitizng Target Populations for the Chicago Housing Trust
    (2023-04-11) Paul, Elizabeth; Ralenkotter, Maria; Resney, Alex
    Our client, The Chicago Housing Trust (The Housing Trust or The Trust), has asked our team to develop a preference policy that will prioritize marginalized Chicagoans – particularly Chicagoans of color and those negatively impacted by past housing policies – applying as first-time homeowners for a Housing Trust- owned unit. The Trust was primarily interested in learning from other cities that have implemented preference policies, both their mistakes and best practices, and hearing from current and prospective homeowners about their experience with accessing housing in Chicago and how The Housing Trust can make units more accessible to them. This report first defines our policy research question before exploring historic, current, and Chicago-specific housing policies that impact access to homeownership. We then review our research methods, which include an analysis of Chicago housing policy, case studies, and interviews. Finally, this report lays out our findings along with four recommendations for The Housing Trust to ensure that its housing stock reaches the intended population. Definitions for housing- related concepts used in our report can be found in Appendix A. A summary of our recommendations are as follows: (1) utilize affirmative marketing, (2) implement a point-system preference policy, (3) provide case workers to applicants and homeowners, and (4) invite current homeowners to join the Housing Trust’s Board.
  • ItemOpen Access
    Public land manager decision-making in East Jemez under ecological transformation
    (2022-04-17) Antonova, Gaby
    Climate-driven ecological transformation characterized by dramatic and irreversible shifts in ecological communities is challenging traditional land management strategies. A growing body of research and technical assistance is emerging to address ecological transformation. One example is the development of the Resist, Accept, Direct (RAD) framework which outlines three distinct land management options in the face of climate change. The resist option allows for managers to resist specific climate impacts and maintain natural and cultural resources within what land managers have historically defined as the “desired conditions.” The accept option allows managers to accept ecosystem changes and alter their strategies to work within a changing environment. The direct option allows park managers to guide “change toward a specific new state because it is feasible to steward change toward a more desirable outcome than what would be achieved with acceptance” (NPS, 2021). Despite the development of this robust framework to address ecological transformation, there has been insufficient focus on social, cultural, and institutional factors that play an important role in shaping managers’ decisions when faced with ecosystem transformation. This project empirically examines decision-making processes that U.S. Forest Service (USFS) and National Park Service (NPS) land managers in East Jemez, New Mexico use to select land management strategies and develop new methods for navigating ecological transformation. East Jemez was selected as a case study site as it is experiencing the firedriven ecological transformation from forests to grassland and shrubland. East Jemez is facing land management challenges associated with the transformation. Through semistructured interviews with 19 state and federal land managers, this study examined two questions: how do natural resource managers make land management decisions and determine future desired conditions during ecological transformation? How does this process vary between different land management agencies, in this case, NPS and USFS? Based on the qualitative analysis of the data collected through interviews with land managers, key findings fall into four categories: • General perceptions of the RAD framework, • Internal factors that influence decision-making, • External factors that influence decision-making, • Barriers to responding to ecological transformation. This report offers recommendations to agencies and agency staff for addressing barriers to responding to ecological transformation, including establishing and communicating agency land management guidelines under ecological transformation, supporting more collaboration through partner groups, and developing protocols to ensure key partner relationships are not affected when there is personnel turnover.
  • ItemOpen Access
    Maximizing Impact: Attracting and Prioritizing Target Population for the Chicago Housing Trust
    (2023-04-19) Paul, Elizabeth, Maria, Alexandra Ralenkotter, Resney
    Our client, The Chicago Housing Trust (The Housing Trust or The Trust), has asked our team to develop a preference policy that will prioritize marginalized Chicagoans – particularly Chicagoans of color and those negatively impacted by past housing policies – applying as first-time homeowners for a Housing Trust owned unit. The Trust was primarily interested in learning from other cities that have implemented preference policies, both their mistakes and best practices, and hearing from current and prospective homeowners about their experience with accessing housing in Chicago and how The Housing Trust can make units more accessible to them. This report first defines our policy research question before exploring historic, current, and Chicago-specific housing policies that impact access to homeownership. We then review our research methods, which include an analysis of Chicago housing policy, case studies, and interviews. Finally, this report lays out our findings along with four recommendations for The Housing Trust to ensure that its housing stock reaches the intended population. Definitions for housing related concepts used in our report can be found in Appendix A. Our recommendations are as follows: (1) Utilize Affirmative Marketing, (2) Implement a Point-System Preference Policy, (3) Provide Case Workers to Applicants and Homeowners, (4) Invite current homeowners to join the Housing Trust's Board.
  • ItemOpen Access
    Governing a Boomburb: Guiding Cary's Growth Into The Future
    (2023-04-21) Hager, William
    What lessons can Cary draw on from Boomburbs around the country to best navigate the governance challenges associated with this form of municipality? Boomburbs are municipalities which have a population of more than 100,000 people and which have grown at a double-digit rate for multiple decades yet remain only the second largest community in their metropolitan area. This report explores the above policy question by highlighting common demographic and governance characteristics of Boomburbs and identifying how Cary aligns with these descriptors. It then utilizes a qualitative research methodology informed by interviews with Boomburb council members and city managers to gather insights on Cary and four other comparable Boomburbs from across the country. This research revealed several common themes between Cary and its peer Boomburbs. Decisions from state legislatures altered political influences in elections within all communities. Several municipalities had well-tenured council bodies guiding their growth and success. Strategic planning and mechanisms to increase citizen engagement in government were common across Boomburbs. Cary stood apart from its fellow Boomburbs, however, by maintaining its identity as a “town” despite its leading growth rate. Cary included more partisan identifiers for current council members in online town materials than other case study locations. The town had the most tenured yet lowest paid town or city council of all five Boomburbs. Promoting pathways to leadership spanning from Cary’s citizen academy to the town council would increase the likelihood that new leaders are prepared to continue on Cary’s current level of excellence and foster greater and more diverse community engagement at higher levels of local government. Combining these pathways with strategies to expand professional development opportunities for government staff and utilize strategic management to establish a unified vision across the town would further fuel Cary’s future success as a Boomburb.
  • ItemOpen Access
    Solar Savings as a Step Toward Economic Stability
    (2022-05-15) Manning, Moses
  • ItemOpen Access
    Ambush on Black Veterans: Foreign Disinformation Swayed the 2016 U.S. Presidential Election by Targeting Black Voters
    (2023-04-19) Jackson, Chandlee A. IV
    A Russian-orchestrated influence campaign spread disinformation using social media during the 2016 United States (U.S.) presidential election. Digital evidence shows that Russian operatives developed presumptions about differing identity groups and tailored their interactions to sow strife between groups. The inferred intent was to influence and negatively impact African Americans’ voting practices during the 2016 election campaign. Russian influence agents targeted the Black community more heavily than any other identity group. Influence operations also targeted veterans and veteran-adjacent communities; therefore, African American veterans (Black Vets) received twice the indoctrination because of their dual identity. The online impersonations of Black people and veterans on social media platforms was problematic for a myriad of reasons, but the Russian leadership’s facilitation of disinformation represents adversarial exploitation of protection gaps uncovered in the Digital Age. Currently the First Amendment inhibits the U.S. government and social media platforms from performing the desired protective measures to maintain a healthy online environment that nurtures an informed citizenry. For Black Vets in particular, foreign entities suppressed the voting power of their ethnic group and sought to instigate members of their profession to join domestic violent extremist groups. The following project will propose that the U.S. government ought to change its approach in teaching digital media literacy competencies so that vulnerable populations receive the care and skills necessary to reduce their potential of becoming radicalized. Russian disinformation on social media and how the U.S. will embrace an identity-centric approach to educating digital media literacy is a matter of U.S. national security.
  • ItemOpen Access
    Combatting Social Isolation, Loneliness, and Elevated Suicide Risk Among Older Adults in North Carolina
    (2022-04) Hendel, Keren; Shipman, Will
    Social isolation (the objective deficit in social relationships) and loneliness (the subjective deficit between an individual’s desired and actual social relationships) are public health issues that affect the health and well-being of many North Carolinians. The North Carolina Department of Health and Human Services (NC DHHS) seeks to develop a strategy to reduce social isolation, loneliness, and elevated suicide risk (SILES). Given the barriers to addressing SILES and the resources of NC DHHS, this strategy should include the formation of a task force, improved social isolation and loneliness screening, and support for community-based organizations. Social isolation and loneliness contribute to higher morbidity and mortality and are widespread. Social isolation and loneliness are associated with greater mortality and increased risk of stroke, heart disease, dementia, diabetes, high cholesterol, chronic conditions, anxiety, depression, and suicide. Prior to the COVID-19 pandemic, 43 percent of adults over age 60 in the United States reported feeling lonely and 25 percent of adults over age 65 were considered socially isolated. By the middle of the pandemic, almost two-thirds of people aged 50 and older in the nation reported social isolation. NC DHHS recognizes the importance of social isolation and loneliness. The Division of Aging and Adult Services (DAAS) developed a SILES working group in April 2020 to begin working to address these key public health issues. Later, DAAS encouraged the North Carolina Area Agencies on Aging to use Older American Act 2021 and various COVID-19 funding to support social connection. The Division of Health Benefits (North Carolina Medicaid) plans to use American Rescue Plan Act funding to address social isolation, loneliness, and elevated suicide risk among home and community-based services beneficiaries. The purpose of this report is to answer the following question: given the recent influx of funding to combat social isolation and loneliness, what strategy or strategies should the North Carolina Department of Health and Human Services pursue to combat these issues? Based on an environmental scan, expert interviews, analysis of the recently conducted Social Isolation and Loneliness in North Carolina Survey, a landscape review of current screenings being used in North Carolina, interviews with other states and large cities, and a guided discussion with NC DHHS stakeholders, we recommend that North Carolina initially focus on coordinated existing efforts throughout the state that aim to improve social connection among older adults. In particular, we recommend NC DHHS: 1. Creates a SILES task force that includes NC DHHS Divisions, community-based organizations, older adult advocates, and researchers. The task force should be led by an individual at NC DHHS who reports directly to executive leadership and for whom SILES work is a top priority of their role. 2. Incorporate the UCLA 3-Item Loneliness Scale into existing Medicaid HCBS screening tools and NCCARE360 screenings. Incorporate referrals to existing SILES programs into the NCCARE360 referral network. Referral services should build over time to include more SILES programs occurring in North Carolina, in particular, those that are targeted toward specific communities of high need. Screening can help identify high-need communities and populations to prioritize for the development of SILES pilots and programs. 3. Fund existing community efforts and pilots through grants. Grants should be awarded in a way that prioritizes innovative programs that support high-need groups and support the state’s goal to create a comprehensive, person-centered SILES approach