Data on Maternal Health and Pregnancy Outcomes from Prisons and Jails: Results from a Feasibility Study

Supervision Violations and Their Impact on Incarceration

People on Electronic Monitoring


OPPAGA Report: Review of the Florida Lottery, 2023

Elementary and Middle School Opportunity Structures That Factor into Students' Math Learning

Occupation Bifurcation: How Non-College Work Has Separated


OPPAGA Report: Florida Growth Fund Program Provided $135 Million in Florida Retirement System (FRS) Distributions in Fiscal Year 2022-23

Infrastructure Inequality: Who Pays the Cost of Road Roughness?

Pre-Employment Transition and Vocational Rehabilitation Services: Experiences in Response to Vermont’s Work-Based Learning Program


OPPAGA Report: Biennial Review of AHCA’s Oversight of Fraud and Abuse in Florida’s Medicaid Program

Child Welfare Outcomes 2020: Report to Congress

Telemedicine Use Among Physicians by Physician Specialty: United States, 2021

February 9, 2024


This report describes the results of a U.S. Bureau of Justice Statistics study that assessed the feasibility of collecting data on maternal health and pregnancy outcomes from prisons and jails. It examined the availability and quality of data, the respondent burden, and the challenges of collecting data on the health and health care of pregnant women in custody at the federal, state, local, and tribal levels. The U.S. Bureau of Justice Statistics will use the findings of this study to help determine the best strategies for implementing national data collections in correctional settings. Findings from this study suggest that the U.S. Bureau of Justice Statistics could succeed in collecting important data on maternal health from state prisons, the Federal Bureau of Prisons, and local jails. The collective interview findings suggest that it is feasible to collect information on maternal health practices; prevalence of pregnant women and demographics; pregnancy test outcomes; types of accommodations, services, and programs available for pregnant and postpartum women; and the organization of maternal health care.

Source: U.S. Department of Justice, Bureau of Justice Statistics

This report, which examines the impact of community supervision violations, is based on 4 years of data from all 50 state corrections departments. The report found that while the number of nationwide state prison admissions from community supervision decreased by one-third from 2018 to 2021, the impact of supervision violations varied vastly state to state. From 2018 to 2021, the number of people incarcerated from community supervision decreased in all but two states – Montana, which had an increase, and Iowa, which had no change. Eighteen states, including Florida, saw decreases of 30%-50% in the number of people incarcerated from community supervision violations; 10 states reduced these admissions by 50% or more. However, despite a national decline, community supervision’s proportion of the prison system has remained relatively consistent since the Council of State Governments Justice Center’s first report, with 44% of all state prison admissions in 2021 being people who violated the terms of their parole or probation sentences.

Source: Council of State Governments Justice Center

Using data collected data from criminal legal system agencies in all 50 states and more than 500 counties, as well as from federal courts, the Federal Bureau of Prisons, and U.S. Immigration and Customs Enforcement (ICE), this report examines the size and scope of electronic monitoring (EM) use in the United States as well as the impacts of EM programs. The report found that in 2021, 254,700 adults were under some form of EM. Of these, 150,700 people were subjected to EM by the criminal legal system and 103,900 by ICE. From 2005 to 2021, the number of people on EM in the United States grew nearly fivefold. Additionally, the number of adults placed on EM by ICE more than tripled between 2021 and 2022, increasing to 360,000. Regional trends in the criminal legal system reveal how EM has been used more widely in some states and cities but increased sharply from 2019 to 2021 across the country: The midwest has the highest rate of state and local criminal legal system EM at 65 per 100,000 residents. In the northeast, EM rates are the lowest of all the regions at 19 per 100,000 residents, but they increased by 46% from 2019 to 2021. The south and west have similar rates, 41 and 34 per 100,000 residents respectively, but the growth rate in the south has outpaced that of the west in recent years – up 32% in the south compared to 18% in the west.

Source: Vera Institute of Justice


Lottery transfers to the Educational Enhancement Trust Fund increased in Fiscal Year 2022-23 to $2.45 billion, $120 million (5%) more than the prior year. According to Department of the Lottery officials, this increase is due to the low operating expense rate while ticket sales have increased. The department continues to outperform the legislative performance standard for its operating expense rate, which is the third lowest in the nation. In the past year, the Lottery made several efforts to increase revenue, including increasing the number of Lottery retailers and recruiting a new chain store partner; offering new games; adding self-checkout QUICKTICKET draw games at approximately 250 Winn-Dixie stores; providing enhancements and upgrades at Walmart Supercenters, Southeastern Grocers stores, and Winn-Dixie liquor stores; and enhancing player engagement. In addition, the Lottery will add 500 vending machines by summer 2024 which is anticipated to increase revenue and will place the number of vending machines at the maximum permitted in the state budget. Several games and product distribution options are available to further increase transfers to education. While the Lottery has taken steps to increase sales, additional actions could further enhance sales and ultimately increase transfers to education. For example, the Legislature could consider authorizing the Lottery to expand current games and product distribution methods to enhance revenues. In addition, the Legislature could consider authorizing or prohibiting the operation of lottery courier services.

Source: OPPAGA

This report explores school structures that support students' mathematics learning across the United States and in the four largest states: California, Florida, New York, and Texas. The authors do not examine the quality of mathematics instruction students receive or how much students have learned. Instead, they consider the ways that elementary and middle schools are organized to provide mathematics learning opportunities. The report found that tracking in mathematics classes starts early in many schools. According to principals' self-reports, a greater proportion of Florida schools group students by achievement level than schools in other states. Furthermore, up to 20% more principals in large and low-poverty middle schools reported grouping students by achievement level into mathematics classes than in smaller and high-poverty middle schools. Additionally, the report found that students who struggle in mathematics classes typically do not get the most experienced and knowledgeable teachers, although state context matters. The report also provides policy recommendations, such as investigating ways to reduce biases in how students are tracked by achievement level within and into mathematics classes and providing opportunities for teachers to build their knowledge of mathematics pedagogy and content.

Source: RAND Corporation

The first moving assembly line changed what it meant to build a car. It also allowed Ford Motor Company to sell automobiles at low prices and employ workers at high wages. A century later, new technologies are having equally as profound impacts on society—changing the landscape of American jobs and driving demand for new types of work. Over the past 30 years, the meaning of a good job has been redefined by the rise of the internet, information technology, and automation —just as Ford’s assembly line transformed work one hundred years ago. But as work has changed, career paths for workers bifurcated—further separating those with a degree from those without. Key findings in this report include that over the last 30 years, the work that non-college and college-educated workers do has bifurcated. The number of full-time workers in managerial and professional occupations has nearly doubled, but workers without a college degree accounted for just 13% of this gain. Non-college workers shifted away from stable jobs that supported a middle-class life to work now at the bottom end of the labor market. From 1992 to 2022, the number of non-college workers in service and transportation jobs surged by 25% to 18 million. The gap in pay between these types of jobs is growing. Today, the average hourly wage of professional class jobs is double that of service and transportation jobs. And professional jobs offer better benefits than service and transportation occupations.

Source: Third Way


As of June 30, 2023, the board’s Florida Growth Fund Program made 145 such investments totaling $998 million; these investments were either direct investments or private equity funds with a Florida presence. This includes new direct investments in 17 companies and 16 private equity funds totaling $75.4 million in Fiscal Year 2022-23. From fund inception in 2008 through June 30, 2023, the program distributed $965.7 million to the Florida Retirement System Pension Fund. During the review period, the amount distributed was $135 million. Since inception, funds within the Florida Growth Fund Program have generally met or exceeded benchmarks set for each fund. The Florida Growth Fund Program’s investments have resulted in economic benefits. As of June 30, 2023, investment managers reported that program investments created 6,783 jobs and made $703.4 million in capital expenditures in Florida during the review period.

Source: OPPAGA

In this research, the authors measure road roughness throughout America using vertical acceleration data from Uber rides across millions of American roads. The measure correlates strongly and positively with other measures of road roughness where they are available, negatively with driver speed, and the authors find road repair events decrease roughness and increase speeds. The authors measure drivers’ willingness-to-pay to avoid roughness by measuring how speeds change with salient changes in road roughness, such as those associated with town borders and road repaving events in Chicago. These estimates suggest the roughness of the median local road in the U.S. generates welfare losses to drivers of at least 31 cents per driver-mile. Roads are worse near coasts, and in poorer towns and in poorer neighborhoods, even within towns. The report finds that a household that drives 3,000 miles annually on predominantly local roads will suffer $318 per year more in driving pain if they live in a predominantly Black neighborhood than in a predominantly White neighborhood. Road roughness modestly predicts subsequent road resurfacing in New York City, but not in three other cities, which suggests that repaving is only weakly targeted towards damaged roads.

Source: National Bureau of Economic Research

This report describes variation in how high school students used services from the Vermont vocational rehabilitation (VR) agency and how a demonstration program emphasizing work-based learning experiences affected that use. State VR agencies offer pre-employment transition services (pre-ETS) and other VR services to high school students. The study compares youth with access to demonstration services (the treatment group) to those using usual services (the control group). Among all control group youth, more than half only used pre-ETS during a 24-month period, while about one-quarter used VR services and the remainder used no services from the VR agency. In contrast, nearly all treatment group youth used some VR services, with a majority (59%) using both VR services and pre-ETS. Control group youth who used pre-ETS and VR services differed from those who did not use these services by gender, disability type, employment, and service receipt characteristics; treatment group youth had fewer such differences. Earnings outcomes did not vary in consistent or interpretable ways. The findings demonstrate how an intervention designed to promote work-based learning experiences increased pre-ETS and VR use and decreased subgroup differences in service utilization.

Source: Mathematica


Statewide Medicaid Managed Care accounts for the majority of state Medicaid expenditures. In Fiscal Year 2022-23 it accounted for 65% of total expenditures, while the fee-for-service program accounted for the remaining 35%. Florida's Medicaid enrollment grew substantially in the wake of the COVID-19 pandemic. Federal legislation resulted in enrollment increases in Florida and across the nation. When new congressional legislation ended these changes and decreased federal funding, states were required to return to normal eligibility and enrollment operations and to conduct eligibility redeterminations. Florida began redeterminations in April 2023. As of October 2, 2023, AHCA reported that Florida is estimated to have the ninth lowest procedural termination of coverage rate among states. The Agency for Health Care Administration’s (AHCA’s) Office of Medicaid Program Integrity has primary responsibility for administering and overseeing fraud and abuse prevention and detection efforts throughout the state’s Medicaid program. In this role, AHCA collaborates with federal and state agencies and managed care organizations (MCOs). AHCA has established annual performance targets for program integrity, with specific emphasis on identifying and preventing overpayments within the Medicaid program. AHCA does not have agency performance targets for the detection and prevention of fraud and abuse. Over the past five fiscal years, the agency has failed to meet its targets for identifying overpayments. During Fiscal Year 2021-22, MCOs identified $187.8 million in overpayments, which was a 23% decrease from the previous fiscal year. In recent years, AHCA has shifted primary responsibility for fraud prevention and detection activities to MCOs. Although these organizations have met AHCA’s contractually obligated performance targets for fraud referrals for Fiscal Year 2022-23, the quality and utility of these referrals is unknown. A U.S. Department of Health and Human Services, Office of Inspector General report estimated that in August 2020, AHCA made capitation payments on behalf of over 55,000 Medicaid enrollees concurrently enrolled in another state, resulting in $15.8 million in total program costs. An estimated $6.9 million of these payments were made on behalf of recipients no longer residing in Florida. In recent years, AHCA has reportedly made efforts to enhance Medicaid program integrity by improving data quality, data analytics, and program oversight. Consistent with prior reports, OPPAGA recommends that AHCA consider taking steps to improve data analytics and program oversight, with particular emphasis on the utility of internal and external performance measures and inter-agency communication.

Source: OPPAGA

This report provides information on national performance as well as the performance of individual states in seven outcome categories pertaining to child abuse and neglect, permanency, increasing placement stability, and reduction of group home placements. Nationally, there were approximately 407,000 children in foster care on the last day of 2020, representing a decrease each year since 2018. During 2020, an estimated 217,000 children entered foster care, and approximately 224,000 children exited foster care. Among the states, the foster care entry rate ranged from 0.9 children per 1,000 in a state’s child population to 13.2 children per 1,000 in a state’s population. Florida’s foster care entry rate was 3.1. During 2020, approximately 618,000 children were confirmed to be victims of maltreatment. The overall national child victim rate was 8.4 child victims per 1,000 children in the population. State child victim rates varied dramatically, ranging from 1.7 to 19.0 child victims per 1,000 children. Florida’s child victim rate in 2020 was 6.6 per 1,000. In 2020, the national median with regard to the maltreatment of children in foster care was 0.28%, with state medians ranging from 0.00% to 2.23%. Florida’s child victim rate was 0.01% of children in care. In 2020, states were mostly successful in achieving permanency (i.e., discharge to reunification, adoption, or legal guardianship) for all children exiting foster care, with a national median of 90.3%. States were less successful in achieving permanent homes for children exiting foster care who had a diagnosed disability (median=82.1%) and for children who had entered care when they were older than age 12 (median=62.9%). In 2020, states continued to struggle with achieving timely adoptions. Nationally, the median for children discharged to a finalized adoption within 12 months of the latest removal was 2.5%, and more than half of states (70%) saw a decline in performance between 2016 and 2020. For adoptions occurring at least 12 months but less than 24 months from entry into foster care, national performance declined 11.3% between 2016 and 2020, with more than half (65%) of states demonstrating a decline. Among Florida children who exited to adoption in 2020, most (35.1%) had spent 24 to 36 months in care, followed by 32.1% who spent 12 to 24 months in care. In 2020, the majority of children in foster care for less than 12 months remained in a stable placement (i.e., having two or fewer placement settings in a single foster care episode), with a national median of 84.5%. States were less successful in achieving placement stability the longer a child spent in foster care. The median across states for children who were in care between 12 and 24 months was 65.4%, and it was 40% for children in care at least 24 months. Florida demonstrated similar trends, with 84.5% of children in care less than 12 months remaining in a stable placement, compared to 65.9% of children in care between 12 and 24 months and 40.5% of children in care for 24 months or longer. Overall, states continued to demonstrate improvement in reducing placements of young children in group homes or institutions. The median decreased from 3.2% in 2016 to 2.6% in 2020 (an 18.8% decline), and 35 states (69%) demonstrated an improvement in performance. Florida’s placement of children age 12 or younger in group homes or institutions decreased 4.4% to 2.3%.

Source: U.S. Department of Health and Human Services, Office of the Administration for Children and Families

The 2019 novel coronavirus (COVID-19) pandemic led to an increase in telemedicine use among physicians, from 15.4% in 2019 to 86.5% in 2021. Interest has increased in how telemedicine has affected a physician’s ability to deliver quality care similar to an in-person office visit, and in technological barriers to telemedicine use. This report describes telemedicine use and challenges among physicians sampled in the 2021 National Electronic Health Records Survey. This report builds upon previous work and describes the use of telemedicine, ability to provide quality care during telemedicine visits, satisfaction with telemedicine, and appropriateness of telemedicine use by physician specialty type. Key findings from the report include that more medical specialists (27.4%) used telemedicine for 50% of their patient visits or more than primary care physicians and surgical specialists. Most primary care physicians (76.7%) and medical specialists (73.1%) were able to provide a similar quality of care during telemedicine visits as in-person visits “to some extent or a great extent” compared with about one-half of surgical specialists (50.6%). Primary care and medical specialists were more likely to be satisfied with telemedicine technology compared with surgical specialists. Surgical specialists were most likely to indicate that telemedicine technology was not appropriate for their specialty or patients (49.7%), followed by medical specialists (26.7%) and primary care physicians (15.5%).

Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention

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