Despite the economic downturn, states and localities have pressed forward, sometimes making wrenching changes to get their fiscal houses in order. The days of reflection and worry have been replaced by growing signs of productivity, hard decision-making and innovation. Now is their time to tackle the big fiscal problems that lie ahead. This year’s Cost of Government Summit, hosted by Governing, explicitly set out to find answers regarding how states and localities will deal with these fiscal issues, such as pension obligations, debt-burdened localities, workforce benefits and Medicaid expansion. State and local officials — along with key thought leaders from major institutions and the private sector — came together for answers to long-term fiscal concerns by examining how regional collaboration can improve economic conditions, crime and the environment. In addition, stakeholders looked at how generational tensions can be reconciled by promoting new approaches to workforce performance improvement. This guide summarizes the ideas that transpired at the Summit and energized the participants.