Hospital-based violence intervention programs (HVIPs) have emerged as an important public health response to community violence. These programs combine the efforts of medical staff and community-based service providers to intervene with victims of violence in hospital settings, connect them with community-based service providers to intervene with victims of violence in hospital settings, connect them with community-based victim services, and reduce future victimization and violent behaviors. Research has indicated HVIPs are effective in reducing repeat victimization, reducing criminal justice involvement, and reducing health care and other costs associated with violence. The programs also address circumstances common to victims of crime, such as disparities in access to health care, transportation, case management, and a range of social determinants of health. This toolkit provides resources that facilitate federal Victims of Crime Act of 1984 (VOCA) state administrators in supporting HVIPs in expanding access to service for victims of violence and work directly with communities of color and other underserved communities to increase health equity in funding for HVIP services, and track progress and address challenges. Suggestions include using a trauma-informed, healing-centered approach, integrating lived experience and survivor leadership, and advocating for equitable policies that benefit the well-being of patients and staff. The Health Alliance for Violence Intervention, with support from the U.S. Justice Department’s Office for Victims of Crime, drew from its experience in providing technical assistance to HVIPs nationally, worked with leaders from groups involved in providing services to victims of violence, and interviewed VOCA administrators and federal and state grant managers.

More than 65% of youth who are arrested every year have mental health conditions, which amounts to more than two-thirds of boys and three-quarters of girls. Often, these needs have gone untreated or misdiagnosed, leading to engagement in the juvenile justice system. In response to these staggering numbers, it is imperative that juvenile justice system stakeholders, particularly families, school administrators, community-based organizations, police officers, defense attorneys, prosecutors, and judges, work together to address the mental health needs of youth. This brief identifies the collaborative role that juvenile justice stakeholders can play in helping to prevent and reduce involvement in the system by addressing youth’s mental health needs. The brief outlines roles that stakeholders such as families, schools, and law enforcement agencies can play when working with youth who are at risk of involvement in the justice system and suspected of having a mental health condition.

States have begun to pass legislation to provide automatic relief for eligible criminal records, potentially reducing the lifelong collateral consequences of criminal justice involvement. Yet numerous historical examples suggest that racially neutral policies can have profoundly disparate effects across racial groups. In the case of criminal record relief, racial equity in eligibility for a clean slate has not yet been examined. The authors find that in California, one in five people with convictions met criteria for full conviction relief under the state’s automatic relief laws. Yet the share of Black Americans eligible for relief was lower than white Americans, reproducing racial disparities in criminal records. The authors identify two policy amendments that would reduce the share of Black men in California with convictions on their criminal records from 22% to 9%, thereby narrowing the difference compared to White men from 15 to seven percentage points. Put another way, an additional one in seven Black men currently has a conviction record, compared to their White counterparts. This would decline to an additional one in 14 if both hypothetical policy amendments were incorporated. The authors close with discussion of criminal history data quality limitations, which pose a second key challenge to equitable implementation of automatic criminal record relief reforms nationwide.

Policies and practices in higher education are largely designed for students who take what is considered to be the traditional path through college: enrolling directly after high school and attending college full time. But there are many other adult undergraduate students whose life circumstances—attending while working full time, working, having dependents, not having high school diplomas—can make it harder for them to reach their educational objectives. While much of the field uses the language non-traditional to describe these learners, this brief refers to adult learners as post-traditional students, a more humanizing term used by the American Council on Education and others. To improve their outcomes, the report suggests several best practices, such as direct institutional and state resources to students with independent status on the Free Application for Federal Student Aid (FAFSA), providing a dedicated, single point of contact for post-traditional learners, and to consider strategies that coordinate and recognize credit for prior learning like credit for college-level learning that took place outside of the college classroom, at both the state and institutional levels.

Paid employment is a common experience in the transition to adulthood. It is also a key path for developing financial independence and relational skills. Research shows that young people with histories of child welfare involvement work less often and earn lower wages during the transition to adulthood than their peers without this experience. However, little is known about whether programs that aim to improve employment outcomes for young people with histories of child welfare system involvement are actually improving employment outcomes. A key finding from the Multi-Site Evaluation of Foster Youth Programs is that many programs serving youth in the Chafee Foster Care Independence Program), the primary source of federal funding for services to support young people in foster care during their transition to adulthood, are not ready for rigorous evaluation because they lack a clearly articulated logic model or are not implemented as intended. To address some challenges for rigorous impact evaluations of programs, the authors conducted formative evaluations for two employment programs. Together, these formative evaluations highlight the importance of building a better understanding of the variations in programs serving young people with histories of child welfare system involvement. This study aims to expand our understanding of what these variations in employment programs are and how they bolster different developmental assets for young people. The authors developed a clearer understanding of the roles that a program’s forms and functions play in how employment programs serve young people at different stages in their transition to adulthood. For example, a residential program can take the form of a youth housing program and provide a career exploration function by providing training in a particular field such a culinary or pet grooming. Or a different residential program may focus on connecting participants to early work experiences and help participants begin to manage household budgets without a direct focus on a specific career pathway.

This report addresses the demographic, economic, and health transitions that have taken place in Asian countries, while considering the wide diversity of economic development throughout Asia. Asia’s aging population is a reflection of the unusually rapid declines in fertility and mortality rates. Just as significant are the sheer numbers involved. As of 2020, the population of Asia exceeded 4.5 billion (including China and India, the two countries with over one billion each), more than one-half the world’s total. There were an estimated 414 million Asians aged 65 and older in 2020, projected to grow to more than 1.2 billion in 2060, which implies that one out of every 10 people in the world will be an older Asian. As aging becomes inevitable across all of Asia, some lower income countries will likely have populations that grow old before they are rich. Close attention to such cases from policymakers and the society at large is needed in order to strengthen existing modes of support. Even in higher income Asian countries, the sheer growing numbers of older adults will require stronger health and social protection systems to address chronic conditions and prevent the rise in common health risks.

Although wages have increased somewhat over the past year, as employers face challenges filling jobs, it is not clear whether this will persist beyond the COVID-19 pandemic as the economy opens back up. The federal Earned Income Tax Credit (EITC) has helped to counter low and falling wages. By providing a refundable credit to low-wage workers at tax time, it has become one of the nation’s most effective antipoverty policies. But most of its benefits go to workers with children. The maximum credit for a worker with two children, for example, is almost $6,000. If there are no minor children in the household, the worker gets a tenth of that amount. This disparity means that a large number of workers with low incomes—more than 20 million people—benefit very little from the EITC. This group includes young women and men without children, older workers with adult children, and non-custodial parents. The Paycheck Plus Demonstration was started in 2013 and, motivated by the earlier expansion proposals, set out to learn more about the potential effects of a bigger credit for workers without dependent children. The demonstration, conducted by MDRC as a randomized controlled trial, offered a bonus of up to $2,000 at tax time to a group of adults with low earnings and without children in two large cities—New York and Atlanta— and tracked them for three years to measure the effects of the program on income, work, and earnings. One The New York study found that the bonus increased earnings, led to small increases in employment rates - largely for women and for a subgroup of particularly disadvantaged men in the study, and did not lead to reduced work effort among higher earners. The bonus income also led to an increase in child support payments by noncustodial parents. It had few overall effects on many other outcomes, such as physical health status or criminal justice involvement. Results from the Atlanta A second study were more muted. Paycheck Plus increased after-bonus earnings, but only in the first year, had no detectable effect on employment rates, and did not reduce earnings among higher earners.

Cyber incidents are occurring with increasing frequency, and these incidents are becoming more disruptive and costlier. Some such incidents exceed stakeholders' capacity to respond using everyday means. The stakes are particularly high with respect to U.S. National Critical Functions (NCFs), functions of government and the private sector so vital to the United States that their disruption, corruption, or dysfunction would have a debilitating effect on security, national economic security, national public health or safety, or any combination thereof. Securing NCFs requires unity of effort within the federal government and effective collaboration and cooperation within state, local, tribal, and territorial governments and the private sector. The Cybersecurity and Infrastructure Security Agency asked the Homeland Security Operational Analysis Center to develop a contingency planning implementation (how-to) guide, including a contingency plan template, that NCF stakeholders could use to develop NCF-specific contingency plans to guide their response to and efforts to mitigate the impacts of a significant cyber incident affecting their NCFs. This report provides an overview of contingency planning for a significant cyber incident, focusing on the importance of planning, the process of developing a plan, and options for operationalizing a plan. The report also summarizes the major concepts that are explored in detail in the separate how-to guide.

Health centers provide comprehensive medical care in medically underserved communities. The number of health centers has expanded in the last decade from 1,124 sites in 2010 to 1,375 sites in 2020. In 2020, nearly 29 million people received medical care from health centers regardless of their insurance status or ability to pay for care. This report examines health center visit rates by various characteristics, like age, sex, insurance status, reason for visit, and services. In 2020, an estimated 12.4 health center visits per 100 people occurred. Most health center visits were made by patients with Medicaid as the primary expected source of payment. Most visits to health centers were for preventive care (33.4%), new problems (32.8%), or chronic problems (32.1%). Screenings, examinations, and health education or counseling were provided at 60.0% of health center visits, and laboratory tests were provided at 40.5% of visits.

This report is the fifth annual report in a series from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2). Using data from interviews administered at child ages 54 and 60 months (i.e., during the child’s fifth year), in addition to data collected from previous years of the study as needed for context, the report addresses three primary research questions: (1) what are the background and environmental characteristics that may influence families’ feeding practices and, ultimately, their children’s nutrition and health outcomes?; (2) what is the influence of WIC on the nutrition and health of children in the study?; and (3) what are children’s nutrient intake, meal, and snack practices, and how do feeding practices influence weight and growth? Findings indicate that the WIC nutrition education is influencing their feeding practices during the child’s fifth year for mothers who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2. Additionally, about 73% of all study mothers report having made, at least, one change due to something they learned from WIC. Among those who made a change, the most frequently cited (39%) important change made was knowing how to choose healthier foods for themselves and their families. However, the findings also indicate that nearly three-quarters (73%) of study children have inadequate intakes of vitamin D. In addition, about one-third (33%) of study children have inadequate intakes of vitamin E.

Over the last decade, the federal Centers for Medicare & Medicaid Services (CMS) has made increasing efforts to implement or promote value-based payment programs for Medicare, Medicaid, and commercial payers, including Alternative Payment Models (APMs) with meaningful upside potential and downside risk. The CMS's Transforming Clinical Practice Initiative (TCPi) was the largest national-scale practice transformation model. The authors analyzed whether practices that joined TCPi were more likely than well-matched comparison practices to newly enroll in Medicare Alternative Payment Models (APMs) from September 2015 through January 2020 (3 months after program end), using 6,958 physician practices enrolled in TCPi and a closely matched comparison group of 6,958 practices. More TCPi practices enrolled in Medicare APMs and Medicare Advanced APMs relative to comparison practices overall and in subgroups, including rural, small, and specialty practices. Results suggest that large-scale technical assistance can boost participation in Medicare APMs for a diverse set of practices. Moving practices into APMs may be a critical step toward improving patients' outcomes, reducing waste in the health care system, and sustaining better results through investment in value and optimal care delivery.