People who live and work in jails, prisons, and detention facilities are at elevated risk for SARSCoV-2 infection, due to close living environments and the high prevalence of pre-existing health conditions. Agencies will be forced, through executive direction, litigation, or necessity (due to rising infections, lack of staff, or medical capacity) to release people in their custody early and to fast-track their usual reentry processes and services. Jails and prisons are beginning to release people. Prisoners who are released will face unprecedented challenges presented by COVID-19, including obtaining necessities such as food and shelter, accessing healthcare and behavioral healthcare, and entering a job market with historically high unemployment. Scattershot approaches to releasing prisoners, without substantial accompanying supports, will diminish prospects for succeeding in the community and may undermine future criminal justice reform efforts. The authors provide several recommendations including expanding access to technology for those released early, ensuring those released early have access to necessary medicine, and enrolling all releases in eligible benefit programs.

Persistent violent and antisocial behavior, as manifested in conduct disorder traits, are associated with a range of cognitive deficits. Individuals with more severe cognitive deficits are more likely to commit violent crimes. Currently, no treatments target improving cognition in high-risk conduct disorder youth. This pilot study tests the feasibility and efficacy of delivering intensive tablet-based cognitive training to adolescent males incarcerated in a youth maximum-security prison. At baseline, participants exhibited significant impairments on neurocognitive measures, relative to age-matched healthy controls. Twelve participants completed training and showed evidence of target engagement, as indexed by improvement in cognitive processing speed. Significant gains were observed in measures of global cognition, with additional gains in cognitive flexibility. Improvements in these measures were positively related to total training time. In summary, both assessments and intervention appear to be feasible, tolerable, and acceptable in incarcerated youth. Intensive cognitive training shows preliminary efficacy in improving neurocognitive performance in key domains, with large effect sizes, and significant performance improvement associations with the time in training.

The U.S. Department of Education’s quality control processes for data it collects from public school districts on incidents of restraint and seclusion are largely ineffective or do not exist, according to the analysis of school year 2015-16 federal restraint and seclusion data—the most recent available. Specifically, the department’s data quality control processes were insufficient to detect problematic data in its Civil Rights Data Collection —data the Department of Education uses in its efforts to enforce federal civil rights laws. For example, one rule the department used to check the quality of data submitted only applied to very large school districts, although the authors’ and department’s own analyses found erroneous reporting in districts of all sizes. The Department of Education also had no rules that flagged outliers that might warrant further exploration, such as districts reporting relatively low or high rates of restraint or seclusion. The authors tested for these outliers and found patterns in some school districts of relatively low and high rates of restraint or seclusion. Absent more effective rules to improve data quality, determining the frequency and prevalence of restraint and seclusion will remain difficult. Further, the department will continue to lack information that could help it enforce various federal civil rights laws prohibiting discrimination. The authors recommend several steps to improve data quality including revising the Civil Rights Data Collection business rule to require that every school district reporting zeros, regardless of district size or numbers of students with disabilities, affirm the zeros are correct during the CRDC data submission process and developing and implementing a Civil Rights Data Collection business rule that targets schools and schools districts that report very high number of incidents and set data-driven thresholds to detect such incidents.

Schools are heralded by some as unique sites for promoting racial equity. Central to this characterization is the presumption that teachers embrace racial equity and teaching about this topic. In contrast, others have documented the ongoing role of teachers in perpetuating racial inequality in schools. In this article, the authors employ data from two national data sets to investigate teachers’ explicit and implicit racial bias, comparing them to adults with similar characteristics. The report finds that both teachers and non-teachers hold pro-White explicit and implicit racial biases. Furthermore, differences between teachers and non-teachers were negligible or insignificant. The findings suggest that if schools are to effectively promote racial equity, teachers should be provided with training to either shift or mitigate the effects of their own racial biases.

State-funded pre-K is an increasingly important part of public education. These programs support early learning and development to better prepare children to succeed in the primary grades and to reduce achievement gaps that emerge well before kindergarten. They also serve the child care needs of some children and families. Many state-funded preschool programs rely on mixed delivery systems of public and private programs, including Head Start, to facilitate integration with child care. Since this report’s first survey in 2002, state-funded pre-K has changed markedly, though year-to-year change has been slow and uneven. States have added more than 930,000 seats, the vast majority of these at age 4. Enrollment of 4-year-olds has expanded by 20 percentage points to 34%. Enrollment of 3-year-olds increased only three percentage points to 6%. More states fund preschool than in 2002. State financial investments in preschool have more than doubled since 2002 when adjusted for inflation. Quality standards have generally improved. This report includes the following lessons learned: The Great Recession officially ended in June 2009, but it was not until the 2010-2011 school year that inflation-adjusted pre-K funding per child nationally began to fall. Real spending declined more the following year. In 2012-2013, states cut pre-K enrollment as real spending continued to fall. As spending declined, so did program quality standards. The impact of these cuts remains today. Despite a brief upturn, pre-K’s long-term growth rate remains lower than before the Great Recession. Some states had not fully reversed their quality standards reductions by 2018-2019. Decreases in pre-K enrollment, quality standards, and funding are not rapidly reversed and can permanently hinder progress.

The lingering effects of the coronavirus crisis will add to the structural changes that were already shifting labor demand and skill content of traditional occupations—exposing workers to displacement, income cuts, or inactivity. This crisis will have persistent effects on economic activity, as the affected, mostly labor-intensive sectors, will need months to come back to speed—if those sectors recover at all. To meet this uphill challenge, it is essential to understand what works in terms of off-the-shelf labor market policies and to learn how to calibrate them to the particular time and space context faced by individual countries and regions—and, last but not least, to put fiscal resources to work to that end. Active labor market policies (ALMP) is a general denomination for specific policies that could be broadly grouped into four big policy clusters—vocational training, assistance in the job search process, wage subsidies or public works programs, and support to micro-entrepreneurs or independent workers. These policies are a big fiscal item in most countries with well-funded welfare states (as a reference, on average, ALMPs account for more than 0.5% of Gross Domestic Product (GDP) in Organisation for Economic Co-operation and Development (OECD) countries. The authors conducted a systematic review of experimental evaluations of the effectiveness of ALMPs worldwide. The authors found individualized coaching or follow-up of the participants, specialized training exclusively focused on a specific industry, and the provision of monetary incentives to trainees all correlated with better outcomes in vocational training programs; ALMPs are pro-cyclical: The effectiveness of a program correlated positively with economic growth and negatively with national unemployment; and training programs tend to be more effective for young people and the authors found no significant differences across genders or educational levels.

This publication offers at-a-glance information about the nonprofit sector. The sheet shows that 1,729,101 nonprofits are registered with the Internal Revenue Service (IRS) and offers information on public charities, foundations, and grant making priorities. Seventy-two percent of nonprofits are public charities, which administer programs, occasionally make grants, and can be small and local or large and national or international. The sheet provides a national map showing the number of public charities per capita in each state. Florida has less than 35 public charities per capita. Seven percent of nonprofits are private foundations which are primarily grant making institutions such as the Bill & Melinda Gates Foundation. Foundations generally fund health or education subject areas.

The structure of health insurance is such that some providers are in contract with one’s health insurance company (in-network) and, therefore, have reduced or covered cost. In contrast, other providers are not in contract with one’s health insurance company (out-of-network) and may result in higher costs. Patients treated at in-network facilities can involuntarily receive services from out-of-network providers, which may result in surprise bills. While several studies report the surprise billing prevalence in emergency department and inpatient settings, none document the prevalence in ambulatory surgery centers (ASCs). The extent to which health plans pay a portion or all of out-of-network providers’ bills in these situations is also unexplored. The authors analyzed 4.2 million ASC-based episodes of care in 2014–17, involving 3.3 million patients enrolled in UnitedHealth Group, Humana, and Aetna commercial plans. One in ten ASC episodes involved out-of-network ancillary providers at in-network ASC facilities. Insurers paid providers’ full billed charges in 24% of the cases, leaving no balance to bill patients. After the authors accounted for insurer payment, they found that there were potential surprise bills in 8% of the episodes at in-network ASCs. The average balance per episode increased by 81%, from $819 in 2014 to $1,483 in 2017. Anesthesiologists (44%), certified registered nurse anesthetists (25%), and independent laboratories (10%) generated most potential surprise bills. There is a need for federal policy to expand protection from surprise bills to patients enrolled in all commercial insurance plans.

During a pandemic, there is a high risk of medical supply shortfalls and inefficient distribution of medical supplies. If different regions face pandemic peaks at different points in time, supply shortfalls in regions suffering high infection caseloads (hot spots) can potentially be reduced by minimizing idle inventory and acquisitions of new supplies in regions with contemporaneously low infection caseloads (cool spots). This publication discusses a potential backstopping mechanism for addressing this inefficient distribution by assuring cool spots that, if they release inventoried supplies to hot spots and delay acquiring new supplies, they will receive priority access to a corresponding quantity of newly produced supplies in the future. If new supplies are not produced as quickly as expected or if the cool spot suffers an outbreak earlier than expected, the promise will be fulfilled by drawing from a centralized, dedicated pool of supplies. This backstopping mechanism thus multiplies the value of resources in a centralized pool by leveraging that pool to increase the share of resources going to hot spots. For this mechanism to work, the pool must draw in more resources over critical periods than it could otherwise provide by simply acting as a direct source of supplies. This paper also offers observations on how to evaluate whether the proposed mechanism could provide benefits over alternative responses in the ongoing coronavirus disease 2019 (COVID-19) pandemic.

Treatment with methadone or buprenorphine is the current standard of care for opioid use disorder. Given the paucity of research identifying which patients will respond best to which medication, both medications should be accessible to all patients so that patients can determine which works best for them. However, given differences in the historical contexts of their initial implementation, access to each of these medications may vary along racial/ethnic lines. This cross-sectional study included all counties and county-equivalent divisions in the U.S. in 2016. Data on racial/ethnic population distribution were derived from the American Community Survey, and data on locations of facilities providing methadone and buprenorphine were obtained from Substance Abuse and Mental Health Services Administration databases. Findings suggest that the racial/ethnic composition of a community was associated with which medications residents would likely be able to access when seeking treatment for opioid use disorder. Each 1% decrease in probability of interaction of an African American resident with a white resident was associated with 0.6 more facilities providing methadone per 100,000 population. Similarly, each 1% decrease in probability of interaction of a Hispanic/Latino resident with a white resident was associated with 0.3 more facilities providing methadone per 100,000 population. Each 1% decrease in the probability of interaction of a white resident with an African American resident was associated with 8.17 more facilities providing buprenorphine per 100,000 population. Similarly, each 1% decrease in the probability of interaction of a white resident with a Hispanic/Latino resident was associated with 1.61 more facilities providing buprenorphine per 100,000 population. Reforms to existing regulations governing the provisions of these medications are needed to ensure that both medications are equally accessible to all.