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Working Poor Families Project;
This policy brief reports on the first three years of an initiative to work directly with five WPFP state partners in AR, CO, GA, KY, and NC to enhance their state's commitment and ability to serve and support adults and children collectively as well as drive local programs to do so by reviewing the efforts of the five state partners. After first providing more background on Two-Generation efforts across the U.S. in recent years, this brief discusses: 1) the WPFP concept and approach to the initiative; 2) the work of the five state partners, including the state systems identified for this work and specific items identified for improvement within those systems as well as progress to date; and 3) lessons learned and observations of this work with a clear recognition of the challenges and complexities inherent in undertaking systems change work.
This paper examines 287(g)'s implementation across multiple counties in North Carolina and identifies its impact on local crime rates and police clearance rates by exploiting time variation in regional immigration enforcement trends. The 287(g) program did not affect the crime rate in North Carolina or police clearance rates but it did boost the number of assaults against police officers.
Foundation for a Healthy Kentucky;
Creating a Culture of Health in Appalachia: Disparities and Bright Spots is an innovative research initiative sponsored by the Robert Wood Johnson Foundation (RWJF) and the Appalachian Regional Commission (ARC) and administered by the Foundation for a Healthy Kentucky. This multi-part health research project will, in successive reports: measure population health and document disparities in health outcomes in the Appalachian Region compared to the United States as a whole, as well as disparities within the Appalachian Region; identify "Bright Spots," or communities that exhibit better-than-expected health outcomes given their resources; and explore a sample of the Bright Spot communities through in-depth, field-based case studies. Taken together, these reports will provide a basis for understanding and addressing health issues in the Appalachian Region. This research initiative aims to identify factors that support a Culture of Health in Appalachian communities and explore replicable activities, programs, or policies that encourage better-than-expected health outcomes that could translate into actions that other communities can replicate.
This first report, Health Disparities in Appalachia, measures population health in Appalachia and documents disparities between the Region and the nation as a whole, as well as disparities within the Appalachian Region.
A Better City facilitated the formation of a team among three of its members – the Massachusetts Institute of Technology, Boston Medical Center, and Post Office Square Redevelopment Corporation – to purchase the output of a large-scale renewable energy facility. This aggregation was unique in the diversity of the partners, the scale of the project, and the mutual benefit to all parties involved. This case study provides lessons learned for organizations interested in aggregating the purchase of renewable energy including: the benefits of renewable energy beyond environmental impact; the value of partnerships and collaboration to yield results; the organizational flexibility gained through renewable energy purchasing; and the necessity for ongoing recruitment and anchor partners.
IZA Institute of Labor Economics;
Black primary-school students matched to a same-race teacher perform better on standardized tests and face more favorable teacher perceptions, yet little is known about the long-run, sustained impacts of student-teacher demographic match. We show that assigning a black male to a black teacher in the third, fourth, or fifth grades significantly reduces the probability that he drops out of high school, particularly among the most economically disadvantaged black males. Exposure to at least one black teacher in grades 3-5 also increases the likelihood that persistently low-income students of both sexes aspire to attend a four-year college. These findings are robust across administrative data from two states and multiple identification strategies, including an instrumental variables strategy that exploits within-school, intertemporal variation in the proportion of black teachers, family fixed-effects models that compare siblings who attended the same school, and the random assignment of students and teachers to classrooms created by the Project STAR class-size reduction experiment.
Center for Health Policy at Brookings;
The health insurance marketplaces created by the Affordable Care Act (ACA) were intended to broaden health insurance coverage by making it relatively easy for the uninsured, armed with income-related federal subsidies, to choose health plans that met their needs from an array of competing options. The further hope was that competition among health plans on the exchanges would lead to lower costs and higher value for consumers, because inefficient, low-value plans would lose out in the competitive market place. This study sought to understand the diverse experience in five states under the ACA in order to gain insights for improving competition in the private health insurance industry and the implementation of the ACA.
In spring 2016, the insurance marketplaces had been operating for nearly three full years. There were numerous press stories of plans' decisions to enter or leave selected states or market areas within states and to narrow provider networks by including fewer choices among hospitals, medical specialists, and other providers. There were also beginning to be stories of insurer requests for significant premium increases. However, there was no clear understanding of how common these practices were, nor how and why practices differed across carriers, markets, and state regulatory settings.
This project used the ACA Implementation Research Network to conduct field research in California, Michigan, Florida, North Carolina, and Texas. In each state, expert field researchers engaged directly with marketplace stakeholders, including insurance carriers, provider groups, state regulators, and consumer engagement organizations, to identify and understand their various decisions. This focus included an effort to understand why carriers choose to enter or exit markets and the barriers they faced, how provider networks were built, and how state regulatory decisions affected decision-making. Ultimately, it sought to find where and why certain markets are successful and competitive and how less competitive markets might be improved.
The study of five states was not intended to provide statistically meaningful generalizations about the functioning of the marketplace exchanges. Rather, it was intended to accomplish two other objectives. First, the study was designed to generate hypotheses about the development and evolution of the exchanges that might be tested with "harder" data from all the exchanges. Second, it sought to describe the potentially idiosyncratic nature of the marketplaces in each of the five states. Political and economic circumstances may differ substantially across markets. Policymakers and market participants need to appreciate the nuances of different local settings if programs are to be successful. What works in Michigan may not work in Texas and vice versa. Field research of this sort can give researchers and policymakers insight into how idiosyncratic local factors matter in practice.
In brief, our five states had four years of experience in the open enrollment periods from 2014 through 2017. The states array themselves in a continuum of apparent success in enhancing and maintaining competition among insurers. California and Michigan appear to have had success in nurturing insurer competition, in at least the urban areas of their states. Florida, North Carolina, and Texas were less successful. This divergence is recent, however. As recently as the 2015 and 2016 open enrollment periods, all of the states had what appeared to be promising, if not always robust, insurance competition. Large changes occurred in the run-up to the 2017 open enrollment period.
Hispanics in Philanthropy;
For the past three-and-a-half years, through the HIP to College initiative, Hispanicsin Philanthropy has worked diligently to strengthen the academic success of Latino students and the long-term community advancement that results from their earning postsecondary degrees. With the support of generous partners, such as the Bill & Melinda Gates Foundation, the HIP to College initiative in North Carolina and Colorado worked to develop networks that support Latino students through high school and into college. Improving outcomes for Latino students is the priority of the HIP Education Focused Initiative. The success of this initiative has been remarkable. HIP is optimistic about the future of this work and its role in cultivating an educational landscape and partnerships in the United States that help Latino students thrive.
Nurse-Family Partnership (NFP);
Nurse-Family Partnership (NFP) is an evidence-based community health program that connects low-income,first-time parents with maternal and child health nurses who provide support for a healthy pregnancy,knowledgeable and responsible parenting, and a strong start in infancy.
A new study by researchers at the University of North Carolina at Chapel Hill evaluated the NFP program's effects in North Carolina, showing statistically significant improvements in two areas critical to infant health and healthcare costs in our state.
Department of Health Policy and Management, UNC Gillings School of Global Public Health;
This is the periodic update on the evaluation of the Nurse Family Partnership program in North Carolina focused on the priority health outcomes of women and infants. During this period, we refined our methodology to more precisely estimate the effect of NFP participation on the health of women and children. In this report, we will report the estimated effect of participation on birthweight, gestational age, NICU admission, and breastfeeding initiation. We will also discuss the differential treatment effect of participation by maternal race as well as variation in estimation between statewide, county and hospital level analysis.
As previously reported, this study focuses on NFP participants in North Carolina and proximal health outcomes as well as health care costs. This study is limited by its relatively small sample size used to analyze uncommon outcomes, suggesting the ability to detect programmatic effects may be limited. In other words, because of the relatively small sample, a priori we might expect to conclude there is no effect when there truly is.
Corporation for Enterprise Development (CFED);
The Assets & Opportunity Scorecard is a comprehensive look at Americans' financial security today and their opportunities to create a more prosperous future. It assesses the 50 states and the District of Columbia on 130 outcome and policy measures, which describe how well residents are faring and what states are doing to help them build and protect assets. The Scorecard enables states to benchmark their outcomes and policies against other states in five issue areas: Financial Assets & Income, Businesses & Jobs, Housing & Homeownership, Health Care, and Education.
Mathematica Policy Research, Inc.;
Mathematica Policy Research examined the implementation of Enroll America's field outreach campaign during the second open enrollment period, to understand whether and how it adapted the campaign compared to its first year activities, to assess second-year performance, and to document Enroll America's expectations for their work in 2015 and beyond. The findings in this report are based on two rounds of interviews with Enroll America staff and outside stake holders conducted in October and November 2014 and again between May and July 2015.
Carsey School of Public Policy at The University of New Hampshire;
This brief documents the proportion of Americans who would have been poor absent the Earned Income Tax Credit (EITC), all else being equal, across 2010–2014. We examine Supplemental Poverty Measure (SPM) rates as well as hypothetical increases in the rates of SPM poverty in the absence of federal EITC benefits. It is important to note that we do not model behavioral changes that might result from the removal of EITC benefits, so the analyses presented here are a simplified representation of such a hypothetical scenario. The SPM is an obvious choice for this analysis because unlike the Official Poverty Measure (OPM), which only accounts for before-tax cash income, the SPM also considers in-kind benefits, tax credits, and out-of-pocket work and medical expenses when estimating resources. We present SPM rates for all individuals (Table 1) as well as for children only (Table 2), analyzing trends across regions, metropolitan status, and by state. Importantly, geographic differences in the cost of housing are accounted for in the SPM rates, and consequently the analyses presented here give a more accurate sense of the poverty reducing impact of EITC benefits.