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IN THIS ISSUE:

CRIMINAL JUSTICE

Capital Punishment, 2023 – Statistical Tables

States of Women’s Incarceration: The Global Context 2025

An Assessment of the Lycoming County Pretrial System


EDUCATION

Case Study of Arizona’s K–12 Education Savings Account Program: What State Policymakers Can Learn

Beyond Tuition: The Hidden Costs of College and Their Disproportionate Impact

Investing in a High-Quality Teacher Workforce: Lessons From Texas Teacher Preparation Programs


GOVERNMENT OPERATIONS

Performance Evaluation of Safe Mobility for Life Coalition’s Outreach Activities to Benefit Aging Road Users

Leveraging Behavioral Science to Improve Access to Public Transit

Federal Infrastructure Spending on Transportation, Four Years after the Infrastructure Investment and Jobs Act


HEALTH AND
HUMAN SERVICES

U.S. Centers for Medicare and Medicaid Services’ Special Focus Facility Program for Nursing Homes Has Not Yielded Lasting Improvements

Supporting Food Security and Access to Indigenous Foods for Children and Families in Tribal Early Childhood Programs

Are Hospital Acquisitions of Physician Practices Anticompetitive?



November 21, 2025

CRIMINAL JUSTICE

This report presents statistics on incarcerated individuals under the death sentence in 2023 and historical trends in executions. Researchers found that, in 2023, 26 states and the Federal Bureau of Prisons held 2,192 incarcerated individuals under sentence of death, a 3% decrease from the prior year. This represented the 23rd consecutive year in which the number of inmates under sentence of death declined. Specifically, while death sentences peaked (59) between 1991-1995 in Florida, individuals sentenced to death declined consecutively from 2011-2023. Researchers also found that California (30%), Florida (13%), and Texas (8%) collectively held more than half of the incarcerated individuals under sentence of death in the United States in December 2023. In the same year, five states, including Florida, executed a total of 24 prisoners. Texas and Florida accounted for 58% of the executions carried out in 2023. Most incarcerated individuals under the death penalty were white males, aged 65 or older, with at least a high school diploma or GED, who were never married. Lastly, most incarcerated individuals under the death penalty had prior felony convictions and were on probation or parole prior to arrest.

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

In the U.S., 614 individuals per 100,000 residents are incarcerated. Specifically, 112 women per 100,000 residents are incarcerated in the U.S. Researchers found that globally, nearly 60% of women were incarcerated, including nearly 200,000 women and girls in the U.S. South Dakota, Montana, and Idaho have higher women’s incarceration rates than any other country in the world. Some U.S. states with the lowest women’s incarceration rates outpace that of nations with armed conflict and political instability, or where laws continue to explicitly subjugate women. For example, Rhode Island, one of the U.S. states with the lowest women’s incarceration rate, incarcerates women at a rate of 28 per 100,000. This is higher than the incarceration rate in Colombia (23 per 100,000), where the women’s prison population has increased more than fivefold since 1991.

Source: Prison Policy Initiative

Various criminal justice stakeholders recognize best practices for high-functioning pretrial programs. These standards cover a variety of topics, including release options following or in lieu of arrest, use of risk assessments, sequential bail review, and pretrial outcome and performance tracking. The Crime and Justice Institute (CJI) compared Pennsylvania’s Lycoming County pretrial release, detention, and supervision practices to recognized best practices for a high-functioning pretrial system. The CJI found that the county’s pretrial system does not meet most recognized best pretrial practices, including a meaningful and timely (within 48 hours of arrest) initial court appearance that includes defense representation, charges reviewed and filed by the district attorney, and judicial decision-making informed by the pretrial services agency’s risk assessment and background investigation; regular court date reminders to individuals with pending cases before each scheduled court date; sharing of pretrial risk assessment information with stakeholders to help inform bail decision-making; an emphasis on least-restrictive nonfinancial release conditions as the primary type of bail; and a system to routinely review whether conditions of bail continue to match the risk levels of release and detained individuals.

Source: Crime and Justice Institute

EDUCATION

The authors examine Arizona’s kindergarten through grade 12 (K–12) Education Savings Account (ESA) program, the oldest program among the 19 states that now have ESAs. ESAs give families with school-aged children public funds to spend on their children’s education if they opt not to enroll them in public schools. Arizona’s program was introduced in 2011, with the first students enrolling in the 2011–12 school year. The program was first targeted to students with disabilities but has since seen numerous eligibility expansions. As of 2022, the program was expanded to allow universal eligibility. These multiple iterations of the ESA program create a unique opportunity to explore different ESA policy designs, many of which mirror approaches used by other states implementing ESA programs. Key findings from the report include that Arizona’s universal ESA policy expansion in 2022–23 led to participation growing from almost 12,000 students in the 2021–22 school year to nearly 90,000 students in 2024–25. Arizona’s spending on ESAs has gone from $2.2 million (in 2025 dollars) in the 2011–12 school year to $886 million in 2024–25. Approximately 7% of Arizona’s school-aged population uses ESAs as of the 2024–25 school year. Prior to universal eligibility expansion, students with disabilities were the largest user group, making up 60% of ESA users. Since the expansion, students with disabilities now make up 18% of ESA users. ESA users tend to come from school districts that have higher achievement levels, serve students from more-affluent backgrounds, and have larger White populations, on average. Families spend roughly 60% of ESA dollars on private school tuition, but a growing portion goes toward other education services. As of the 2023–24 school year, 28% of ESA funds that have been awarded have not been spent. Arizona’s ESA program has induced growth in the education marketplace, with the number of vendors on Arizona’s online education marketplace increasing from 1,339 in 2021 to 6,091 by 2024, and the estimated number of private schools in Arizona increasing from 451 to 515 since 2022. Since the universal ESA policy was implemented, private elementary school and high school tuition rates have grown 12% and 5% respectively, although these increases are not definitively in response to universal ESAs.

Source: RAND Corporation

With national conversation centered around high tuition prices, higher education faces an uphill battle in improving total cost of attendance estimates, and addressing the financial barriers outside of tuition. Eight in 10 (79%) respondents to the Hope Center’s 2023–24 Student Basic Needs Survey who had previously stopped out of college and subsequently re-enrolled, or who were considering stopping out of college, reported it was due to basic needs insecurity or financial reasons. About four in 10 (39%) of those who had stopped out and re-enrolled gave post/insufficient financial aid as a top reason; one-third didn’t have enough money for living expenses (34% or had an unexpected financial emergency (32%), and 24% cited the cost of course materials. One-third (32%) of currently enrolled students considered stopping out in the six months leading up to being surveyed in October 2024, nearly six in 10 at-risk students come from low to low-middle-income households and more than half (53%) of at-risk students with a job work more than 20 hours per week. A 2022 survey found that 72% of responding community colleges had an open basic needs center, with an additional 22% reporting progress on opening a center.

Source: Inside Higher Education

Texas has the largest teacher workforce of any U.S. state, with over 375,000 teachers in 2023–24. However, this workforce is characterized by a revolving door of teachers entering and, too often, quickly leaving the profession, with the state having experienced persistent teacher shortages for well over a decade. To address vacancies, many Texas districts have needed to rely on short-term approaches that can ultimately undermine student learning, including the frequent hiring of underqualified or underprepared teachers. The Texas teacher attrition rate exceeds the national average by over 50%, and a large majority of first-year teachers in Texas enter the profession via either alternative routes that abbreviate coursework and allow the candidate to become teacher of record while still training, or no certification route at all. These accelerated pathways enable classroom vacancies to be filled more quickly, but they are an unsustainable solution to the teacher shortage. Research shows that candidates coming through these pathways leave the profession at much higher rates than candidates prepared with a full complement of coursework and clinical experience. Moreover, students taught by alternatively prepared teachers or uncertified teachers in the state experience substantially smaller achievement gains than students taught by traditionally prepared teachers. These circumstances warrant a deep look at educator preparation programs that prepare teachers who remain in their positions and help maximize their students’ opportunities and outcomes. To this end, this study documents the design, structure, and content of three high-quality educator preparation programs in Texas that offer full-year clinical teaching pathways: the University of Houston, the University of Texas at El Paso, and the University of Texas–Rio Grande Valley (UTRGV). The study aims to illuminate replicable practices for other educator preparation programs. While each of the highlighted programs feature residencies as a model for candidates’ clinical experiences, with UTRGV also featuring a yearlong clinical experience called the Student Teacher Educator Preparation: University Partnership, many of the insights shared here apply to educator preparation programs using other preparation models. The study also seeks to inform the ongoing evolution of statewide policies—including Texas’s recent statewide investment in teacher residency programs—that support preparation to develop a well-qualified, stable, and diverse workforce able to meet the wide-ranging needs of students from day one on the job.

Source: Learning Policy Institute

GOVERNMENT OPERATIONS

As people age, their vision, cognition, and reaction time decrease, increasing their risk for serious injury or death if involved in an accident. As of 2023, more than 21% of Florida’s residents were aged 65 or older, with a projected increase to nearly 27% by 2050. To meet the current and future transportation needs of Florida’s aging population, the Florida Department of Transportation created Safe Mobility for Life (SMFL), a statewide program and coalition to improve the safety, access, and mobility of elderly individuals through outreach and education. Researchers found that overall, SMFL proved to be economically viable and effective in reducing accidents involving the aging population. Specifically, researchers found that SMFL’s outreach efforts reduced accidents involving the aging population by employing different strategies, including educational material distribution, outreach events, public service announcements, and social media campaigns. Researchers estimated that every dollar spent on outreach resulted in approximately five dollars in accident reduction benefits, illustrating the financial viability of the SMFL’s efforts.

Source: Florida Department of Transportation Research Center

Transit agencies nationwide are modernizing fare systems by adopting digital and contactless payment technologies that enable riders to pay fares using credit and debit cards, reload­able transit cards, mobile apps, and other contactless devices. These expanded payment options can make it easier to board and transfer between transit vehicles, streamlining operations and making public transportation more convenient for many riders. However, as digital and contactless payments become more popular, transit agencies are considering limiting or eliminating cash as a payment option, which raises the question: Does shifting away from cash have a cost? Reducing the places where cash is accepted risks reducing access to public transportation for populations with limited use of banking services and mobile technology, such as immi­grants, people from low-income communities, and seniors. Because transportation is essential for gaining access to the many resources that affect people’s economic opportunities, health, and social needs, access to public transportation can be particularly important for these groups. This challenge is ripe for a behavioral science approach—a systematic method of addressing barriers to desired behaviors that applies research on how people make decisions and take actions. By uncovering the barriers that specific groups of riders face when adopting new payment methods, transit agencies can develop tailored solutions to help ensure that technological advancements do not widen the access gap for these riders. In 2020, MDRC partnered with King County Metro, a leading transit agency in Seattle and the Puget Sound region, to help shed light on how transit riders make choices about how to pay their fares and to help inform policy decisions about fare pay­ment options. This brief describes the behavioral science–driven research initiatives that MDRC used to help King County Metro navigate this rapidly changing landscape.

Source: MDRC

Signed into law in November 2021, the federal Infrastructure Investment and Jobs Act (IIJA), also known as the Bipartisan Infrastructure Law, directed billions of dollars toward improvements for the nation’s infrastructure systems, including transportation, water, broadband, and energy.. This research finds that the law has been associated with an overall increase in ground transportation capital investment compared with previous years, but that increase is concentrated among highway projects. Meanwhile, overall public transit capital spending has flatlined, and rail projects have experienced a net decline in spending. Additionally, researchers found evidence that high construction cost inflation has reduced the effects of the IIJA’s investments because the ability to build projects has been limited by faster-than-inflation increases in labor and materials costs. In the years preceding IIJA’s passage, inflation-adjusted overall transportation investment had increased, with highway and transit spending being 51% and 75% higher, respectively, in 2021 than 40 years before. Operations and maintenance spending had also increased steadily, while capital spending (e.g., new roads or transit lines) has varied over the years. But the federal government’s share of overall infrastructure spending had generally declined before IIJA, especially on highway investment, as state and local governments have taken on larger roles. In 2020, the share of the federal budget spent on highways and transit was substantially lower than in the late 1970s. This shift can be partially attributed to increased federal expenditures on health care (which have risen even as grants to states and localities for other policy areas have fallen), though infrastructure spending as a share of the total economy has also declined. In 1970, governmental entities spent 1.9% of the gross domestic product on transportation infrastructure. In 2020, that share was just 1.6%. Data since 2023, however, suggest that the large boost in highway and street spending may have been short lived, with a decline in inflation-adjusted spending over the past two years.

Source: Urban Institute

HEALTH AND HUMAN SERVICES

Some nursing homes persistently fail to provide adequate care to residents, putting their health and safety at risk. As mandated by federal law, the U.S. Centers for Medicare and Medicaid Services (CMS) implements the special focus facility program to address quality issues in nursing homes with the lowest compliance rates. This review assesses the effectiveness of the special focus facility program in reducing non-compliance with federal requirements and ensuring nursing home residents receive quality care. The U.S. Office of Inspector General (OIG) found that nursing homes that complete the special focus facility program do not maintain improvements made in the program over the long term. Specifically, between 2013 and 2022, nearly two-thirds (64%) of the nursing homes received a serious deficiency within 3 years of completing the program. In addition, about one-third of nursing homes received a serious deficiency in each of the 3 years after completion. Many nursing homes in various states received low compliance rates. For example, in most states (31 of 49), more than half of nursing homes received a serious deficiency after program completion. The OIG provided several recommendations to CMS to improve program effectiveness and ensure compliance with federal requirements. This includes CMS imposing more non-financial enforcement remedies that encourage sustained compliance, incorporating nursing home ownership information into the special focus facility program, and assessing the extent to which it took enhanced enforcement actions and the effectiveness of those actions. Florida was one of 10 states selected for interviews to discuss the special focus facility program.

Source: U.S. Department of Health and Human Services, Office of Inspector General

The U.S. Administration for Children and Families (ACF) aims to support Tribal Nations and communities in providing critical nutrition during children’s formative years, facilitating access to healthy and nutritious food in early childhood programs, and preserving culture through traditional Indigenous foods and revitalization of traditional agricultural practices. This memo details ways that the ACF early childhood funds may be used to connect young children and families with traditional indigenous foods and food practices. This guidance addresses the use of federal ACF early childhood funds. The Child and Adult Care Food Program (CACFP) is a federal program that provides reimbursements for nutritious meals and snacks to eligible children and adults who are enrolled for care at participating Head Start programs, child care centers, family child care homes, and adult day care centers. While not all traditional indigenous foods meet CACFP requirements, food may be used to round out the meal, improve acceptability, and satisfy participants’ appetites. For example, acorns do not count toward the meats/meat alternatives component due to their low protein and iron content, but may still be served alongside a reimbursable meal or snack. Tribal Nations may also expend the Child Care and Development Fund (CCDF) to cultivate, collect, prepare, and provide traditional foods in child care settings. The CCDF funds expended for these activities would count towards the minimum 9% quality expenditure requirement for the fund. The Head Start Program Performance Standards prioritize nutrition services that are culturally and developmentally appropriate and meet each child’s individual needs. These standards provide flexibility for Tribal programs to support food sovereignty and food security according to local needs.

Source: U.S. Administration for Children and Families

This paper empirically analyzes the effects of mergers between complementary firms on competition and pricing. As these non-horizontal mergers have become more common, there is increasing interest in evaluating both potential efficiencies such as eliminating double marginalization and potential anticompetitive effects such as foreclosure and recapture. The mergers studied – hospital acquisitions of physician practices – have reshaped the $1 trillion U.S. physician industry, nearly doubling the share of physicians working for hospitals between 2008 and 2016. Researchers combined novel data and machine learning algorithms to identify a large number of integration events, spanning a wide range of markets with different competitive circumstances. They merged the integration events with claims data from a large national insurer to study their effects on prices. Focusing on childbirths, the most ubiquitous admission among the privately insured, researchers found that, on average, these mergers led to price increases for hospitals and physicians of 3.3% and 15.1%, respectively, with no discernible effects on quality measures. Using demand estimation to characterize substitution patterns for both physicians and hospitals, researchers constructed tests that demonstrated price increases were larger among transactions with greater scope for foreclosure and recapture. Estimates suggest that the costs of these mergers of hospitals and physicians have been substantial, and the mechanism tests offer guidance in predicting where the anticompetitive effects of non-horizontal mergers are likely to be strongest.

Source: National Bureau of Economic Research


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POLICYNOTES
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PolicyNotes, published every Friday, features reports, articles, and websites with timely information of interest to policymakers and researchers. Any opinions, findings, conclusions, or recommendations expressed by third parties as reported in this publication are those of the author(s) and do not necessarily reflect OPPAGA's views.

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