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IN THIS ISSUE:

CRIMINAL JUSTICE

Mortality in a Multi-State Cohort of Former State Prisoners, 2010-2015

A Welfare Analysis of Medicaid and Crime

What Will Shape The Future of Courthouse Design?


EDUCATION

Elevating School Leadership in State Policy

Preparing for Tomorrow's Middle-Skill Jobs: How Community Colleges Are Responding to Technology Innovation in the Workplace

An Estimated 1.1 Million Teachers Nationwide Had At Least One Student Who Never Showed Up for Class in the 2020-21 School Year


GOVERNMENT OPERATIONS

New Census Data Shows a Huge Spike in Movement Out of Big Metro Areas During the Pandemic

Lessons and Takeaways from Supporting Small Businesses to Improve Job Quality: Seven Tips for Workforce Organizations

Guidebook for Effective Policies and Practices for Managing Surface Transportation Debt


HEALTH AND
HUMAN SERVICES

Key Factors in Designing the Health System–Community Pathways Program for African American/Black Children and Young Adults

Trends in Hospital Prices Paid By Private Health Plans Varied Substantially Across the U.S.

Dental Care Utilization Among Adults Aged 18−64: United States, 2019 and 2020



April 29, 2022

Criminal_Justice
CRIMINAL JUSTICE

This report explores the role that race/Hispanic origin, other demographic characteristics, and custodial/criminal history factors have on post-prison release mortality, including on the timing of deaths. It also assesses whether conditional release to community supervision or reimprisonment may explain the higher post-release mortality found among non-Hispanic whites. In the second part of the analysis, the report estimates standardized mortality ratios by sex, age group, and race/Hispanic origin using the U.S. general population as a reference. The data come from state prison releases from the U.S. Bureau of Justice Statistics’ National Corrections Reporting Program (NCRP). The NCRP records were linked to the Census Numident, a data source for all-cause mortality, to identify deaths occurring within five years from prison release. Records were linked to previous decennial censuses and survey responses to obtain self-reported race and Hispanic origin if available. The report findings confirms at the multi-state level findings previously reported from state-level studies. Non-Hispanic white former prisoners were more likely to die within five years after release, and also more likely to die in the initial weeks after release, compared to other racial minorities and to Hispanics. In addition, as reported by state-level studies, mortality was higher among individuals with a history of multiple imprisonments prior to their 2010 release than for those with only one term in prison.

Source: Bureau of Justice Statistics

The authors calculate conservative estimates for the marginal value of public funds (MVPF) associated with providing Medicaid to inmates exiting prison. These MVPF estimates, which measure the ratio between the benefits associated with the policy (measured in terms of willingness to pay) and its costs net of fiscal externalities, range between 3.44 and 10.61. A large proportion of the benefits that the authors account for are related to the reduced future criminal involvement of exiting inmates who receive Medicaid. Using a difference-in-differences approach, the authors find that Medicaid expansions reduce the average number of times a released inmate is re-imprisoned within a year by about 11.5%. The authors use this estimate along with key values reported elsewhere (e.g., victimization costs, data on victimization and incarceration) to calculate specific benefits from the policy. These benefits include reduced criminal harm due to reductions in reoffenses; direct benefits to former inmates from receiving Medicaid; increased employment; and reduced loss of liberty due to fewer future reimprisonments. Net-costs consist of the cost of providing Medicaid net of changes in the governmental cost of imprisonment; changes in the tax revenue due to increased employment; and changes in spending on other public assistance programs. The authors interpret the estimates as being conservative, because they err on the side of under-estimating benefits and over-estimating costs when data on specific items are imprecise or incomplete. The findings are largely consistent with others in the sparse literature investigating the crime-related welfare impacts of Medicaid access, and suggest that public health insurance programs can deliver sizeable indirect benefits from reduced crime in addition to their direct health-related benefits.

Source: Social Science Research Network

Trends in court management are driven by not only operational (internal) factors, but also responses to our rapidly changing world (external). These factors require architects and court planners to reexamine how spaces are designed to accommodate functional, environmental, and societal needs and expectations. The authors outlined four trends that would likely make a significant impact on court facility planning and design. These trends include the reduced need to go to a courthouse because of emerging technologies and declining caseloads and the adoption of evidence-based practices, including restorative justice. Additional trends are a desire to enhance public trust and increase access to justice; the evolving workforce and the skills needed, including how to attract and retain court staff by considering their generational expectations; and the adaptation to global and societal changes, including climate, increased multimodal transportation options, and security.

Source: National Center for State Courts

Education
EDUCATION

School and district leaders significantly impact school culture and climate, influencing student learning and teacher retention. Thus, high-quality preparation and in-service pipelines are critical to supporting schools and educational programs, as unprepared school leaders are less likely to improve student outcomes and are more likely to leave their schools than their more-prepared and better-supported peers. To address the changing roles of school leaders — and to address turnover — states are enacting legislation in two main areas: 1) strengthening the candidate pipeline and 2) ensuring school leaders are represented in the policymaking process. This report examines recent state actions to support school leaders, including legislative examples from 13 states, including Florida. Policy ideas include salary supplements for school principals willing to work in low-performing schools (North Carolina); development of an online clearinghouse with data-supported information related to student achievement and learning, civic education, coaching and mentoring, mental health awareness, technology in education, distance learning, and school safety (Florida); and requiring state board of education membership to include a school superintendent as a nonvoting member (Nevada).

Source: Education Commission of the States

Community colleges throughout the nation have long been instrumental in providing workforce education to both adult and traditional-age students seeking good middle-skill jobs. Yet, across sectors, these jobs are changing. The increased use of technologies such as robotics and artificial intelligence are altering the kinds of skills and the level of skills that these jobs require. This report describes a study conducted by researchers from Community College Research Center and the Massachusetts Institute of Technology’s Task Force on the Work of the Future to understand how community colleges are adapting their workforce programs to changing skill demands, diversifying pathways to certificates and degrees, and grappling with equity concerns. The authors spoke with over 200 administrators, faculty, and staff at eight community colleges to learn about each college’s recent experiences with employers and students in the context of workforce programming in three occupational fields—allied health, information technology, and advanced manufacturing—that are undergoing rapid technological innovation. Interviewees from the colleges emphasized four categories of skills that employers are increasingly seeking: foundational skills in math, reading, and writing; technical skills for specific positions; digital literacy skills to interpret, analyze, and communicate using digital platforms; and a broad mix of interpersonal and cognitive skills central to collaboration, critical thinking, and customer service. The report also identifies key considerations for community colleges that want to respond effectively to evolving skill demands including modifying program curricula, reorganizing college structures and supports for workforce students, and addressing equity concerns surrounding access to technology as well as enrollment, retention, and completion of underserved students in particular programs.

Source: Community College Research Center

The federal Coronavirus Aid, Relief, and Economic Security (CARES) Act includes a provision for the U.S. Government Accountability Office (GAO) to report on its ongoing monitoring and oversight efforts related to the COVID-19 pandemic. As part of GAO's body of work to understand the impact of COVID-19 on public K-12 education, GAO contracted with Gallup to conduct a nationally representative survey of public school teachers about their experiences during the 2020-21 school year on a variety of topics. This report provides information on (1) how widespread was the issue of K-12 public school students not showing up for class in school year 2020-21, (2) obstacles these students faced in showing up, and (3) the characteristics of the schools these students were registered to attend. Nearly half of K-12 public school teachers had at least one student who never showed up for class in the 2020-21 school year. The majority of these teachers said that, compared to a typical year, they had more students who never showed up for class. A variety of obstacles kept students from showing up, including limited or no adult assistance at home and competing demands on students' time such as providing care to a family member. These students predominately came from majority non-White and urban schools.

Source: U.S. Government Accountability Office

Government Operations
GOVERNMENT OPERATIONS

Recently released U.S. Census Bureau population estimates emphasize that it was domestic out-migration that exerted an outsized demographic impact on large metropolitan areas during the prime 12 months of the COVID-19 pandemic. These estimates—for the period July 1, 2020 to July 1, 2021—reveal an absolute decline in the aggregate size of the nation’s 56 major metropolitan areas (those with populations exceeding 1 million). At the same time, smaller metro areas, as a group, experienced higher population growth than in each of the previous two years, while non-metropolitan America showed the greatest annual population gain in more than a decade. This analysis examines annual population changes for major metro areas and core urban counties over the 2010-2021 period based on the latest census population estimates. The analysis provides an assessment of how each demographic component—domestic migration, international migration, and natural increase—impacted area population change up to and through the most recent pandemic year. The results show that each of these demographic components continued and often exacerbated trends that were already evident before the pandemic. Most importantly, the results emphasize the outsized role of domestic migration in dispersing population to smaller-sized places in the prime pandemic period of 2020 to 2021.

Source: Brookings Institution

According to the Small Business Administration, small businesses account for providing nearly half of all jobs in the United States. In recent years, the Aspen Institute’s workforce development partners across the country have noted a growing demand for employer engagement practices that enable collaboration and innovative solutions in connecting people to good jobs. In response, the Aspen Institute developed this guide containing tips and practices for creating trusted relationships with small business employers focused on improving job quality. The guide compiles seven lessons for small business prospecting, recruitment, and ongoing engagement. The lessons, which include building a list of businesses in the community likely to be open to partnerships to improve job quality and framing partnership goals in ways that will allow the employer to see the value in employment improvements, are based on experience working with Pacific Community Ventures and workforce partners to conduct job quality-focused business advising pilots with small businesses across the country. Although there is no one-size-fits-all approach to developing relationships with employers, the authors note that asking lots of questions and tailoring engagement to the local context is key. The guide also recommends additional resources, including Pacific Community Ventures’ Good Jobs Good Business Toolkit and Aspen Institute’s Job Quality Tools Library.

Source: Aspen Institute

The passage of the federal Dodd-Frank Wall Street Reform and Consumer Protection Act and the COVID-19 pandemic are among the factors that have made the environment for tax-exempt debt issuers increasingly challenging and complex. This guide is designed to help surface transportation agencies improve the development and execution of debt management policies, procedures, and practices. It provides surface transportation debt-financing practioners with a detailed step-by-step guide to debt issuance and management process and highlights a diverse suite of effective practices issuers can use to inform their decisions. By using debt, a transportation agency can complete a capital project with a repayment schedule that spreads the cost of that project over its useful life, with the purchaser of the debt receives a reasonably reliable source of investment income. Many factors govern debt issuance, including statutory authority, project and/or program needs, federal rules and regulations, and the economy. This guidebook describes the federal institutions and tools available to state and regional debt issuers, and provides guidance and effective practices for each phase of the debt issuance and management process, including: 1) the decision process; 2) individual transaction preparation and development; 3) marketing and placement of individual transactions; and 4) post-issuance compliance.

Source: National Academies Press

Health and Human Services
HEALTH AND HUMAN SERVICES

Many of the ethnic and racial workforce inequities in the United States are present in health care systems. Low representation of African American/Black individuals in the health care system workforce can be traced to a history of exclusionary practices that leave such individuals less likely to pursue health careers. Past research found that low representation is driven by inequities in health, education, and employment that are a result of structural racism. This report describes the development of key factors in framework design for the Health System–Community Pathways Program, which aims to increase representation of African American/Black communities in the health care system workforce and improve the quality of their experience in pursuing careers in these fields. The program framework of key factors is informed by an environmental scan, interviews and focus groups, and an expert discussion panel session. Key findings include that to boost the number and quality of experience of African American/Black learners and ultimately their representation in health care, the following factors are key to program design: (1) student recruitment, admission, and retention, (2) mentor recruitment and training, (3) programming, (4) program outcome measurement, and (5) long-term program sustainability strategies. Also, admissions committees should be more diverse, social and financial support should be provided to students, and students should be encouraged to participate in decision-making and leadership of curriculum committees and oversight boards. Different types of mentor-mentee relationships should be encouraged to support student success in the program, including peer-peer, near-peer, and senior, and mentors should be trained in racism, micro-aggression, unconscious bias, and cultural understanding. Institutional changes in hiring practices would encourage a more diverse faculty and future mentorship pool. Program evaluation plans should be established to capture feedback on program administration. Programming should include educational and non-educational support and clinical experiences to expose students to opportunities in health care professions. Finally, longitudinal financial support is crucial to eliminate budgetary constraints and maintain program continuity.

Source: RAND Corporation

Commercial health plans pay higher prices than public payers for hospital care, which accounts for more than 5% of U.S. gross domestic product. Crafting effective policy responses requires monitoring trends and identifying sources of variation. Relying on data from the Healthcare Provider Cost Reporting Information System, the authors describe how commercial hospital payment rates changed relative to Medicare rates during 2012–19 and how trends differed by hospital referral region (HRR). The authors found that average commercial-to-Medicare price ratios were relatively stable, but trends varied substantially across HRRs. Among HRRs with high price ratios in 2012, ratios increased by 38 percentage points in regions in the top quartile of growth and decreased by 38 percentage points in regions in the bottom quartile. The findings suggest that restraining the growth rate of HRR commercial hospital price ratios to the national average during the sample period would have reduced aggregate spending by $39 billion in 2019.

Source: RAND Corporation

Oral health is an essential component of overall health and well-being. Along with good oral hygiene, an important factor of oral health is regular dental care. However, about 35% of adults aged 18 and over did not have a dental visit in 2019, and predictors such as age, race, sex, and socioeconomic status were associated with delayed dental care among adults in the United States. In 2020, many dental practices limited their hours and services in response to the COVID-19 pandemic. This report uses data from the 2019 and 2020 National Health Interview Survey (NHIS) to describe recent changes in the prevalence of dental visits among adults aged 18−64. The authors found that between 2019 and 2020, the percentage of adults who had a dental visit in the past 12 months decreased in all family income levels, among all races and origin groups, and in all urban and rural areas. A previous study reported several predictors of unmet dental need among adults in the United States. Therefore, the decline in dental visits between 2019 and 2020 may be attributable to other factors in addition to the impact of the COVID-19 pandemic.

Source: National Center for Health Statistics


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POLICYNOTES

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