grey literature March 2008 archives
March 31, 2008
OBJECTIVE. The Federal Employees Health Benefits Program implemented full mental health and substance abuse parity in January 2001. Evaluation of this policy revealed that parity increased adult beneficiaries? financial protection by lowering mental health and substance abuse out-of-pocket costs for service users in most plans studied but did not increase rates of service use or spending among adult service users. This study examined the effects of full mental health and substance abuse parity for children. METHODS. Employing a quasiexperimental design, we compared children in 7 Federal Employees Health Benefits plans from 1999 to 2002 with children in a matched set of plans that did not have a comparable change in mental health and substance abuse coverage. Using a difference-in-differences analysis, we examined the likelihood of child mental health and substance abuse service use, total spending among child service users, and out-of-pocket spending. RESULTS. The apparent increase in the rate of children's mental health and substance abuse service use after implementation of parity was almost entirely due to secular trends of increased service utilization. Estimates for children?s mental health and substance abuse spending conditional on this service use showed significant decreases in spending per user attributable to parity for 2 plans; spending estimates for the other plans were not statistically significant. Children using these services in 3 of 7 plans experienced statistically significant reductions in out-of-pocket spending attributable to the parity policy, and the average dollar savings was sizeable for users in those 3 plans. In the remaining 4 plans, out-of-pocket spending also decreased, but these decreases were not statistically significant. CONCLUSIONS. Full mental health and substance abuse parity for children, within the context of managed care, can achieve equivalence of benefits in health insurance coverage and improve financial protection without adversely affecting health care costs but may not expand access for children who need these services.
- Based on SAMHSA's Treatment Episode Data Set (TEDS), adolescents aged 12 to 17 accounted for 8% of admissions to substance abuse treatment in 2006; however, they represent 48% of all admissions reporting inhalants.
- Females comprised a larger proportion of adolescent admissions reporting inhalants than of adolescent admissions not reporting inhalants (41% vs. 30%).
- In 2006, 45% of adolescent admissions reporting inhalants had a concurrent psychiatric disorder in contrast to only 29% of their counterparts who did not report inhalants.
- Inhalants were the most frequently reported class of illicit drugs use in the past year among adolescents age 12 (3.4%) or age 13 (4.8%).
- Combined data from SAMHSA's 2002 to 2006 National Surveys on Drug Use & Health found an annual average of 593,000 youths aged 12 to 17 used an inhalant for the first time in the 12 months prior to their survey interview.
- Among past year new inhalant users aged 12 to 15, the three most commonly used types of inhalants were: glue, shoe polish, or toluene; spray paints; and gasoline or lighter fluid. In comparison, nitrous oxide or "whippets" were the most common type of inhalant used among past year new inhalant users aged 16 or 17.
The number of persons aged 50 years and older living with HIV/AIDS has been increasing in recent years. This increase is partly due to highly active antiretroviral therapy (HAART), which has made it possible for many HIV-infected persons to live longer, and partly due to newly diagnosed infections in persons over the age of 50. As the US population continues to age, it is important to be aware of specific challenges faced by older Americans and to ensure that they get information and services to help protect them from infection.
The goal of this project was to assist agencies and organizations who are involved in the handling of case of adolescent abuse and neglect by educating professionals on how to serve adolescents more effectively. The project consisted of four separate components: 1. develop a core curriculum focused on issues unique to adolescent maltreatment, 2. promote the dissemination of the core curriculum to a multi-disciplinary group of teen workers through a training summit, 3. to develop resources to assist multi disciplinary child abuse teams (MDTs) as they strive to better serve maltreated adolescents and 4. to develop a web-based training resource for youth workers.
We have developed a Program Logic Model for the Improvement of Outcomes for Children in the Child Welfare System as a Result of Father Involvement. This conceptual model is based upon our comprehensive review of the available research, and displays the ideal model service program, with the goal of developing knowledge about how non-resident fathers and paternal kin impact child safety, permanency, and well being.
March 28, 2008
This monograph is designed to provide context about human trafficking in Ohio to help inform and shape public discourse and practical responses to it. To do so, it systematically explores human trafficking in terms of its existence and characteristics and in terms of how the criminal justice and social service communities have responded to it. The goal is to provide policymakers and practitioners with information to help improve their efforts to protect and provide services to victims and to bring perpetrators to justice. This monograph will also be of value to legislators and practitioners in other states who are concerned about this issue, as well as to researchers who are seeking to betterunderstand human trafficking and the social response to it.
Marriage has become an increasingly important topic in academic and policy research. A burgeoning literature suggests that marriage has a wide range of benefits, including improvements in individuals’ economic well-being and mental and physical health, as well as the well-being of their children (Lerman 2002; Ross et al. 1990; Waite and Gallagher 2000; Wilson and Oswald 2005). Inspired, in part, by these potential benefits of marriage, several large-scale federal initiatives have been launched in recent years that aim to encourage and support marriage. This synthesis focuses on recent research evidence concerning one of these potential benefits of marriage—the effects of marriage on health. In general, married people are healthier than those who are not married across a wide array of health outcomes (Schoenborn 2004). The existence of an association between marriage and health does not necessarily imply that marriage causes better outcomes, however. In particular, people who marry may already be healthier than those who do not, and this may be the reason for the better health of married adults. An examination of the relevance of these patterns for public policy must include careful consideration of whether the association between marital status and various health measures indicates that getting and staying married actually improves health.
The General Social Care Council, working in partnership with the Commission for Social Care Inspection, the Social Care Institute for Excellence, the Children’s Workforce Development Council and Skills for Care, has been working for some time on a statement defining the roles and tasks of social work. Since this work started, the policy agenda for social care has moved on significantly and in particular, the Government has published Putting People First, on the transformation of adult social care and the Children’s Plan, which sets direction for children’s services. In the light of these developments, the Government has welcomed the joint statement on the roles and tasks of social work and has asked that it be used as a source document for the development of the social care bodies’ strategic work and noted that further work which will be needed to align the content of the statement with the emerging workforce strategies for adult and children’s services.
In 2003, about 56 percent of those eligible to participate in the Food Stamp Program actually participated. The participation rate varied substantially across States, ranging from a high of 83 percent in Oregon to a low of 43 percent in Massachusetts. Using data for 2003 from the Food Stamp Program Quality Control and Current Population Survey, this study examined factors that help to explain the variation. Results show that different population characteristics across States are a major factor because different types of eligible people tend to participate at different rates. States with a higher share of households headed by elderly people had lower rates, while those with a higher share of households without earnings and headed by nonelderly people had higher participation rates. Yet, substantial variation remained after “standardized” State participation rates were calculated that adjust for these compositional differences. Attempts to further explain these standardized rates by State policies and economic conditions were unsuccessful, perhaps due to the limited sample size and imprecise measures of policies.
2008At the end of 2003,* an estimated 1,039,000 to 1,185,000 persons in the United States were living with HIV/AIDS. In 2006, 35,314 new cases of HIV/AIDS in adults, adolescents, and children were diagnosed in the 33 states with long-term, confidential name-based HIV reporting. New HIV/AIDS diagnoses tell us how many people have been diagnosed with HIV or AIDS, but do not necessarily represent new HIV infections because a person may have been infected in years past but received a diagnosis in 2006.
With the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), policymakers and researchers have recognized the importance of employment and earnings as a key way out of poverty and dependency for single mothers. During the middle and late 1990s, the Temporary Assistance for Needy Families (TANF) program, aided by a strong economy, helped move many recipients off the welfare rolls and into work. Several studies have looked at the labor force transitions of former welfare recipients, but few have focused on earnings and income progression, poverty dynamics, and the pathways out of poverty for single mothers (including those who have never received welfare). Single mothers represent a group vulnerable to extensive contact with poverty, and it is important to discern their prospects for long-term self-sufficiency. This study seeks to broaden knowledge about the extent to which single mothers remain out of poverty and the factors most strongly associated with their continued economic progress. We used the 2001 Survey of Income and Program Participation (SIPP) data, collected by the U.S. Bureau of the Census, to examine the income and employment experiences of single mothers who exited poverty. We identified single mothers who exited poverty during 2001, and tracked their experiences over the subsequent two-year period.
The SHS is a rich source of information covering communities, transport and local government. This publication notice presents a range of results based on the main findings from the survey. Further details on the trends over time for the above topics can be found at the Data Trends section of the SHS website.
March 27, 2008
Sure Start has pioneered an integrated approach to children’s services, bringing services together around the needs of children and families. As such, the programme foreshadowed many of the objectives of the wider Every Child Matters (ECM) reform of children’s services and from 2003/4 Sure Start has been central to the delivery of the five ECM outcomes. Together with extended schools and working within the wider strategic framework provided by children’s trusts at local authority level, SSCCs offer a new universal service for all children and families while keeping a clear focus on the needs of the most disadvantaged.
Since 1982, states have increasingly utilized Section 1915(c) waivers and optional state community-based programs to shift long-term care for the aged and disabled from institutions to the community. New rules introduced under the Deficit Reduction Act (DRA) of 2005 provide states with even more flexibility to provide home and community-based long-term care services to their low-income populations. Two overarching goals underlie these policies: (1) to provide long-term care services more cost-effectively; and (2) to give aged and disabled people more options in how they receive their care. As baby boomers enter their senior years and increase the need for long-term care services nationally, information about how Medicaid community long-term care programs have functioned in the past will be critical for assisting states in choosing how to utilize the new options provided under the DRA. Until recently, only limited aggregate data and some national surveys have been available to examine Medicaid community-based long-term care service use and compare it with use of institutional care. The Medicaid Analytic eXtract (MAX) data system produced by Centers for Medicare & Medicaid Services now enables much more detailed analyses of long-term care utilization and expenditures at the person level. This study evaluates the potential of using MAX Person Summary files to examine how successfully states have rebalanced their long-term care systems and how Medicaid enrollees who utilize community-based long-term care services differ from people in institutions.
This is the first in a series of Issue Briefs produced under a contract with the Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation (ASPE), to conduct a study of HHS programs serving human trafficking victims. Funded in fall 2006, the purpose of this 12-month exploratory project is to develop information on how HHS programs are currently addressing the needs of victims of human trafficking, including domestic victims, with a priority focus on domestic youth. This project also consists of reviewing relevant literature, and identifying barriers and promising practices for addressing the needs of victims of human trafficking, with a goal of informing current and future program design and improving services to this extremely vulnerable population. This issue brief focuses on minors who are victimized by sex traffickers across the United States and is intended to provide practical information about the characteristics and needs of these minors, and describe the type of residential programs and facilities currently providing services for this population. The promising practices discussed here were identified by directors and staff of residential facilities housing and serving minor victims of domestic trafficking, juvenile corrections facilities, programs for runaway and homeless youth, child protective services personnel, and law enforcement.
Maltreated children younger than age 3 constitute a vulnerable group in America. Experts have argued that young children are particularly susceptible to the trauma of maltreatment because they rely on others for their basic survival and do not have the capabilities to flee, report, or protect themselves from abuse and neglect (Kaufman & Henrich, 2000; Smyke, Wajda-Johnston, & Zeanah, 2004). Statistics indicate that 79% of all abuse-related fatalities occur when children are the age of 48 months or younger (National Clearinghouse on Child Abuse and Neglect Information, 2005). Additionally, although the rate of substantiated child abuse and neglect for children ages 18 and younger has slightly decreased from 1990 to 2003, the rate of victimization of children younger than age 3 continues to be of concern. In 2003, the national rate of substantiated maltreatment for children younger than age 3 was 16.4 per 1,000 (National Clearinghouse on Child Abuse and Neglect Information, 2005). Moreover, evidence suggests that approximately 21% will experience subsequent maltreatment (Palusci, Smith, & Paneth, 2005). Infants and toddlers also constitute one of the fastest growing maltreated groups in Child Welfare Services (Berrick, Needell, Barth, & Jonson-Reid, 1998; Wulczyn, Barth, Yuan, Jones-Harden, & Landsverk, 2005). The goal of this paper is to describe the most common problems that maltreated infants and toddlers experience and to highlight the benefits of early interventions for this population.
This joint paper by HM Treasury and the finance ministries of Sweden and Germany describes a socially inclusive response to globalisation that combines modern economic and social policies to deliver sustainable economic growth and social inclusion.
March 26, 2008
The Licensing Act 2003, which came into force at the end of November 2005, abolished set licensing hours in England and Wales. Opening hours of premises are now set locally through the conditions of individual licences. The aim was to liberalise a rigid system whilst reducing the problems of drinking and disorder associated with a standard closing time. The Act gave licensing authorities new powers over licensed premises, whilst giving local people more of a say in individual licensing decisions. It was hoped that in the longer term its provisions – coupled with other government initiatives – would help to bring about a more benign drinking culture.
Recent policies encourage the development of programs designed to improve the economic status of low-income nonresident fathers and the financial and emotional support provided to their children. This brief provides ten key lessons from several important early responsible fatherhood initiatives that were developed and implemented during the 1990s and early 2000s. Formal evaluations of these earlier fatherhood efforts have been completed making this an opportune time to step back and assess what has been learned and how to build on the early programs' successes and challenges.
Most previous studies of subsequent reports alleging maltreatment of the same child or of revictimization have included only small populations, administrative data from only one State, or relatively short observation periods. Furthermore, the literature has not always been clear as to which category of repeated activity has occurred. Was the child rereported? Was the child rereported and found to be a victim? Was the child rereported and not found to be a victim? This paper uses the following terminology:
- Referral: the process that results in the agency’s decision to either provide an investigation or assessment or to screen out the referral;
- Report: a referral that has been accepted for investigation or assessment;
- Initial Report: the first investigation or assessment within an observation period that occurs for a specific child who has not been the subject of a prior investigation or assessment;
- Rereport: the second, third, fourth, or subsequent report that alleges a child has been maltreated and that receives an investigation or assessment by the CPS agency (also called reinvestigation);
- Victim: a child who has been determined by the CPS agency to have been maltreated;
- Recurrence: the second, third, fourth, or subsequent time that a child has been found to be a victim of maltreatment (also called revictimization or repeated maltreatment); and
- Nonvictim: a child who has not been found to have been maltreated.
ERS's Food Assistance and Nutrition Research Program (FANRP) supports intramural and extramural research on a wide range of policy-relevant food assistance and nutrition topics. The three perennial program themes are (1) diet and nutritional outcomes, (2) food program targeting and delivery, and (3) program dynamics and administration. The core food and nutrition assistance programs include the Food Stamp Program, the child nutrition programs, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This report summarizes FANRP's activities and accomplishments in fiscal 2007.
ERS's Food Assistance and Nutrition Research Program (FANRP) supports intramural and extramural research on a wide range of policy-relevant food assistance and nutrition topics. The three perennial program themes are (1) diet and nutritional outcomes, (2) food program targeting and delivery, and (3) program dynamics and administration. The core food and nutrition assistance programs include the Food Stamp Program, the child nutrition programs, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This report summarizes FANRP's activities and accomplishments in fiscal 2007.
When a child is born to a married couple, the husband is presumed to be the child's legal father and paternity does not need to be established. However, non-marital children must have their legal paternity established in order to give the child the right to such benefits as child support payments, social security payments and insurance benefits, inheritances, and the father's medical history. Paternity also is a prerequisite for establishing a father's legal right to have access to the child in order to develop emotional and social ties with the child, and to have a role in decisions about the child's life such as religious affiliation or place of residence. In the past, paternity was primarily established by courts when the mother or the child support enforcement agency filed a paternity suit in order to pursue child support. A judge or jury established paternity based on testimony, physical appearances, or blood type. Contested cases were common and paternity trials were seen as cumbersome, expensive and uncertain in their results. With the development of more sophisticated technology, courts have come to rely on DNA testing, especially in contested cases, because testing can determine genetic parentage with more than 99 percent accuracy. If paternity is contested in a case in the Title IV-D Child Support Enforcement Program, the child support enforcement agency must pay for genetic testing if either party requests it, although they may recoup testing costs from the father if paternity is established. An enhanced federal financial participation rate of 90 percent is available for the state costs for genetic testing in Title IV-D cases.
A principal goal of Sure Start Local Programmes (SSLPs) has been to enhance the life chances of young children and their families by improving services in areas of high deprivation. SSLPs were set up between 1999 and 2003 and were experimental in the sense of trying out different ways of working with deprived communities where provision had been poor for years. They represent an intervention unlike almost any other undertaken to enhance the life prospects of young children in disadvantaged families and communities. A key difference is that
programmes are area-based, with all children under four and their families living in a prescribed area serving as the “targets” of intervention. This has the advantage of services within a SSLP area being universally available, thereby limiting any stigma that may accrue from individuals being targeted.
March 25, 2008
This report presents findings from an interview survey of recent claimants of incapacity benefit. It examines the characteristics and circumstances of new claimants of incapacity benefit.
Over the past decade an interest in fathers and their contributions to family stability and children’s healthy development has heightened the attention paid within the child welfare field to
identifying, locating, and involving fathers. Many of the children served by child welfare agencies have nonresident fathers. In addition, the Adoption and Safe Families Act of 1997 renewed focus on expediting permanency for children in out-of-home placement. Engaging fathers of foster children can be important not only for the potential benefit of a child-father relationship (when such a relationship does not pose a risk to the child’s safety or well-being), but also for making placement decisions and gaining access to resources for the child. Permanency may be expedited by placing children with their nonresident fathers or paternal kin, or through early relinquishment or termination of the father’s parental rights. Through engaging fathers, agencies may learn important medical information and/or that the child is the recipient of certain benefits, such as health insurance, survivor benefits, or child support. Apart from the father’s potential as a caregiver, such resources might support a reunification goal or a relative guardianship and therefore enhance permanency options for the child.
ADs began as simple requests to avoid medial treatment that would prolong life in undesirable conditions. However, they have evolved, becoming increasingly detailed and specific, often containing patient preferences for a variety of medical treatments in hypothetical medical scenarios. The activities leading up to the completion of an AD -- discussion of clinical circumstances and prognosis, understanding a patient’s goals in this clinical context, and outlining plans for future care to approximate those goals -- constitute the process of advance care planning (ACP), which is central to end-of-life decision making and AD completion. ACP, in its most advanced form, is a comprehensive, ongoing, and holistic communication pattern between a physician and his or her patient (or the patient’s designated proxy) about values, treatment preferences, and goals of care. ACP broadens the framework of ADs by emphasizing not only decisions about whether to use a treatment but also by making practical arrangements (e.g., anticipating treatment modalities to have them in place). Additionally, ACP helps to identify what course serves the patient best and then outlines specific steps to make that course more likely. Thus, ADs are not an end in themselves; rather, these documents are most effective when incorporated into a comprehensive ACP process and the patient’s goals are incorporated into the care provided by the health care system to the patient. This report examines the empirical evidence about the degree to which ADs and ACP have met their intended goals. We explore what the medical literature reports concerning the use of ADs and ACP, disparities among groups in their use, and interventions to enhance the use and value of ADs and ACP.
Building up assets and avoiding excessive debt can help families insure against unforeseen disruptions, increase economic independence, and improve socio-economic status. Assets are especially important for low-income families because they can limit the likelihood of material hardships. However, a comprehensive portrait of the balance sheets of low-income households does not exist. There is little available information on crucial questions, such as: What are the asset holdings of low-income households? Do a large proportion of American families do too little saving and investing to create a healthy balance sheet? This report begins to paint a portrait of the assets of low-income households by synthesizing current literature in answering the following two research questions: (1) What are the significant assets of low-income households? And (2) what are the significant liabilities of low-income households? It describes what is known and not known about assets in these households and sets the stage for future research and policy discussion.
This paper, the second in this technical assistance series, is based on knowledge gained from field experience, the literature on child welfare privatization and on prior research conducted by the Quality Improvement Center on the Privatization of Child Welfare Services funded by the Children's Bureau, U.S. Department of Health and Human Services. It will describe variations and similarities in program and fiscal design elements of current privatization initiatives. As described in the first paper in this series, privatizing a service or a service system is complex and politically charged. System goals must be established, target populations selected, contract services and administrative systems designed, and contract payment methods tailored to the needs of the public agency and abilities of the private provider community. Each component must be aligned to meet agency goals. This paper presents a range of program and fiscal design elements for public agency administrators to consider, and highlights some lessons learned from state and private agency administrators that have privatized child welfare services.
John Walters, Director of National Drug Control Policy, today highlighted new data showing significant reductions in meth and cocaine positivity rates in the American workforce, as well as continued disruptions in the supply of both drugs.
This informal guidance explains the background and operation of the new ill-health retirement benefit provisions as they will apply in the new-look local government pension scheme after 31 March 2008.
March 24, 2008
This guidance suggests that structural neuroimaging, using methods called magnetic resonance imaging or computed axial tomography scanning, is not recommended for use routinely to examine all people who have had a first episode of psychosis.
This report focuses on adults with SMI served by the public mental health system. It aims to identify and describe the range of SDC programs for this group currently being pursued by states and bring together existing evidence relating to the impact of these programs on individuals and on state resources. In doing so, it attempts to contribute to ongoing debate about effective strategies for improving the quality and outcomes of the public mental health system. It is early in the development of self-direction for individuals with SMI and the number of consumers currently served by these programs remains very small. Therefore, the findings and conclusions presented here are preliminary and further investigation will be required before definite conclusions can be drawn. The report is aimed primarily at state and local-level policy-makers and individuals in consumer or other advocacy organizations who are interested in self-direction and want to learn from the experiences of other states in shaping their own approach to self-direction. It is hoped that the report will also be of interest to a broader policy audience interested in improving the quality of mental health services, as well as those interested in self-direction across disability groups.
How households cope with financial emergencies depends largely on the resources at their disposal. Differential access to good financial options affects how much households pay for credit in a time of need, which can vary substantially. Using data from the Making Connections Cross-Site Survey (2002–2004), we examine how households with incomes over $30,000 and those with incomes below $30,000 would respond in a financial emergency and find that in general, higher-income households were more likely to use conventional methods while lower-income households were more likely to use alternative (and often more expensive) methods to pay unexpected bills.
This report presents State estimates for 23 measures of substance use or mental health problems based on the 2005 and 2006 National Surveys on Drug Use and Health (NSDUHs). Sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), NSDUH is an ongoing survey of the civilian, noninstitutionalized population of the United States aged 12 years or older. Interview data from 136,110 persons were collected in 2005-2006 . . . Separate estimates have been produced for four age groups: 12 to 17, 18 to 25, 26 or older, and all persons 12 or older. Also in this report are estimates for persons aged 12 to 20 for two of the measures—past month alcohol use and binge alcohol use.
With the 2008 presidential election in full swing,health care reform has jumped to the top of the nation's domestic policy priorities—and with good reason. Growing evidence indicates that the U.S. system falls short in critical areas. The number of Americans without health insurance is climbing steadily: 47 million people were uninsured in 2006,an increase of 8.6 million—more than 18% —since 2000. In addition, an estimated 16 million Americans are underinsured and paying high out-of-pocket costs for their care. Even people with good insurance coverage are feeling the effects of higher out-of-pocket health care costs, which are causing them to cut back on their retirement saving contributions. Meanwhile, the quality of care is highly variable and delivery of care is often poorly coordinated, driving up costs and putting patients at risk. In short, our health system is failing to perform as it should. With rising costs straining family, business, and public budgets, access deteriorating, and quality variable, improving health care performance is a matter of national urgency.
The prevalence of HIV infection among adults aged 18–49 years residing in households in the United States was 0.47% for the period 1999–2006. Men were more likely to be HIV positive than women. Race/ethnic disparities in HIV infection were also seen. Non-Hispanic blacks were more likely to be HIV positive than all other race/ethnic groups. Infection with HSV-2 was significantly associated with HIV infection among the total population aged 18–49 years and especially so among the non-Hispanic black population. In 1999–2006, nearly one-quarter of HIV-positive individuals but only 1% of the HIV-negative individuals aged 18–49 years had low CD4 counts (a marker of decreased immune function). Approximately one-third of HIV-positive persons had healthy immune systems as compared with 90% among those HIV negative.
This document sets out the government's commitment to unlocking the talents, not of some of the people, but of all of the people and seeks views on the ways to make changes which give people locally more influence, control and ownership of local services such as employment, health, education and transport.
March 21, 2008
This paper provides a synthesis of the emerging literature on the nexus between incarceration and homelessness. The authors explain how the increasing numbers of people leaving carceral institutions face an increased risk for homelessness and, conversely, how persons experiencing homelessness are vulnerable to incarceration. The authors review recent efforts to address reentry issues and review research results on studies of homelessness among prison and jail populations and research on incarceration among people who homeless. After reviewing common barriers to housing for people who have been incarcerated, the authors assess what is known about the effectiveness of services and housing interventions to address these barriers and outline needs for future research.
Since 1968, the Panel Study of Income Dynamics (PSID) has collected economic, demographic, and social data on a national sample of the U.S. population. The PSID was established to examine the dynamics of economic life, particularly dynamics in poverty status. As a result, the PSID has been widely used by poverty researchers, with 390 publications on “poverty” listed in the PSID bibliography as of October 2007. This paper has two goals: to guide researchers through the process of calculating the poverty rate from the PSID for each year from 1968 to the present; and to compare the level and trend in PSID poverty rates to that of the official Census Bureau rates that are based on the March Current Population Survey (CPS).
For the 1998 Symposium on Homelessness Research, rural homelessness was not assigned as a paper topic in its own right. Due to its increasing significance, the authors prepared a paper on rural homelessness for the 2007 Symposium. Given the somewhat limited formal research available, the authors supplemented their literature review with information from government documents and technical assistance materials as well as input from an expert panel of researchers and practitioners. The paper summarizes what is documented to date about the characteristics of people who are homeless in rural areas and examines whether rural homelessness and the service approaches to address it can be differentiated from urban homelessness. The authors identify gaps in current knowledge about rural homelessness and recommend new directions for research.
In their Code of Ethics, the IASW aims to provide members with the principles upon which their social work practice should be based and on joining the Association, members agree to comply with the Code of Ethics. As it can be difficult in some circumstances to see how these principles can be applied in the workplace, the IASW has developed this Code of Practice for members, which is the practical application of the Code of Ethics to members' professional working lives. This is a recommended standard of practice only. The IASW can refuse membership to anyone who is proven to have failed to meet these standards but does not have the authority to remove a social worker from their workplace as the IASW is not a regulatory body. However members and indeed all social workers are bound by the terms of their employment contract and their conduct can be open to scrutiny by a court of law.
Over the last three decades, structural changes in the American labor market eliminated many highly‐paid, stable jobs that had previously been available to workers with a high school diploma or less. Job security is important, particularly for the least advantaged, who may be less able to adjust to income losses than other workers and less able to plan for the future when jobs are not secure. Job loss is likely to have deleterious consequences for less‐educated workers as they are less likely than others to receive severance packages and more likely to have difficulty finding new jobs. This paper addresses several questions about changes in employment stability over the last three decades: How likely is it that a man who is employed in one year is unemployed two years later? Conversely, how likely is it that a man who is unemployed in one year is employed two years later? How have these probabilities changed over time? How do trends in employment security differ for workers classified by education and race?
Alma Molino, a graduate student in Clinical Psychology at Rosalind Franklin University of Medicine and Science, was selected through a competitive process to prepare a paper on her research on runaway and homeless youth. The author used data collected from callers to the National Runaway Switchboard to describe the characteristics and issues facing a large national sample of youth who have run away or are in crisis, and to examine the associations between these issues and status as a street youth (runaway, throwaway or homeless) or non-street youth (considering running away or being in general crisis). The relationship between the type and number of issues and the frequency of running behavior is also assessed.
In recent years there has been increased interest in providing consumers with more choice about who provides the public services they receive. Vouchers are one strategy for delivering public services in a way that makes the customer the central figure in deciding when and where to receive services, so that the funding relationship between the customer and the provider is similar to transactions in the private market. Vouchers also present a unique opportunity to expand the role of faith- and community-based organizations (FBCOs) in the network of publicly funded services. Organizations receiving direct federal funding may not use the monies for religious activities such as worship or proselytizing. However, an organization that receives funds indirectly does not need to separate religious activities from government-funded services. The key to indirect funding mechanisms, such as vouchers, is that they allow the customer to make an independent choice from among an array of providers and present an avenue through which customers can use public funds to receive faith-infused services.
March 20, 2008
This report examines how income distributions change when the definition of income is varied to reflect the inclusion or exclusion of different components. The measure of household income
reported in the publication Income, Poverty, and Health Insurance Coverage in the United States: 2005 (P60-231) uses the pretax, money income concept. Money income in this instance includes cash income before taxes are paid. The government provides resources to
households through cash and noncash transfer programs. These programs may be open to all or limited to those with incomes below set amounts. Holding other income components constant, transfers from the Social Security Administration, Veterans Administration, and state governments increase household income. Payroll, state, and federal tax liabilities reduce household income. Certain tax credits, such as the Earned Income Tax Credit and the Additional Child Tax Credit, are refundable and may increase household income.
In this paper, the authors cite research indicating that youth may be the single age group most at risk of becoming homeless, yet comparatively little research has been done in the past decade on this vulnerable population. Some important progress has been made, including longitudinal studies on youth “aging out” of foster care. After reviewing the characteristics of homeless youth, the authors review recent research findings on the homeless youth population and interventions developed to address their housing and service needs. These include interventions directed at youth themselves (education, employment, social skills training) as well as family-focused strategies. The authors conclude with future directions for both research and practice.
The prevalence of overweight and obesity has increased for all children, even among low-income children, many of whom are food insecure and face several stressors. In this article, we investigate whether economic stressors and food insecurity influence childhood overweight using data from the Panel Study of Income Dynamics and its second Child Development Supplement. The results indicate no significant relationship between food insecurity and childhood overweight, but two types of economic stressors have a positive association with children’s risk of overweight, namely financial and community stress. A clear policy implication is that reducing childhood overweight is another potential benefit from helping families avoid stress due to economic difficulties
Debra Rog and John Buckner report that since the mid-1990s, there has been continued research and policy interest in understanding the characteristics and needs of families and children who become homeless, especially in understanding the heterogeneity within the population and whether a“typology” of families can be created (i.e., distinguishing families with greater needs for services and housing from those with lesser needs.) The authors review the findings from recent studies on homeless families and children and summarize the descriptive and outcome findings from evaluations of housing and service interventions and prevention efforts. With respect to children, research has focused on understanding and documenting the impact of homelessness on children. Rog and Buckner emphasize that that many of the challenges homeless families and children confront are also experienced by families that are very poor but not homeless, pointing to the need for further research on how to target assistance most efficiently to minimize the incidence and duration of homelessness for low-income families and children in general.
This report presents data on income, earnings, and poverty based on the 2006 American Community Survey (ACS), with some comparisons to 2005 data. (A description of the ACS, which provides information on the country’s economic wellbeing, is provided in the text box “What Is the American Community Survey?”) This report uses the data collected in the ACS to produce estimates of detailed socioeconomic characteristics for the United States, states, and lower levels of geography.
In 2001, the Government published the National Sexual Health and HIV Strategy and one of the recommendations is the provision of more comprehensive and integrated sexual health services. One of the commitments in the strategy was to undertake an evaluation of different models of One Stop Shops. This report, which has just been published provides valuable findings and information for PCT commissioners and service providers considering an integrated approach as well as those already providing integrated services.
March 19, 2008
Study Overview
This is the second in a series of Issue Briefs produced under a contract with the Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation (ASPE), to conduct a study of HHS programs serving human trafficking victims. Funded in the fall of 2006, the purpose of this exploratory project is to develop information on how HHS programs are currently addressing the needs of victims of human trafficking, including domestic victims, with a priority focus on domestic youth. This project also consists of reviewing relevant literature, and identifying barriers and promising practices for addressing the needs of victims of human trafficking, with a goal of informing current and future program design and improving services to this extremely vulnerable population. This issue brief focuses on the identification of international and domestic victims of human trafficking in the United States. Critical to identifying someone as a victim is knowing first who meets the legal definition of a trafficking victim. The definition as set forth in the Trafficking Victims Protection Act of 2000 (TVPA) is presented in the insert on this page, and this brief presents the inherent challenges to identifying victims based on this definition, as well as promising strategies undertaken by law enforcement, service providers, and other organizations to identify and reach victims.
This inquiry takes up the question of how bureaucratic proceduralism operates in benefits delivery and, specifically, whether it produced exclusionary effects in the case of welfare delivery. Bureaucratic proceduralism, a construct of this analysis, is defined as organizational practices occurring through the interaction of formal rules and procedures with informal administrative activities. This focus on proceduralism directs empirical attention to the processes that affect the cost of claiming, not on the categorical standards for eligibility themselves. It recognizes that eligibility rules are not self-executing, but depend on the formal and informal steps, interactions, and judgments that constitute the business of claimsmaking at the street-level. Using data from the National Survey of America’s Families, this inquiry addresses two empirical questions. First, was bureaucratic proceduralism a factor in declining welfare caseloads in the period post-welfare reform? Second, did proceduralism have differential effects on welfare claimants, depending on their socio-economic status, race, or ethnicity? That is, did proceduralism produce inequality in access to benefits?
This report presents data on income, poverty, and health insurance coverage in the United States based on information collected in the 2007 and earlier Annual Social and Economic Supplements (ASEC) to the Current Population Survey (CPS) conducted by the U.S. Census Bureau. Data presented in this report indicatethe following:
• Real median household income increased between 2005 and 2006
for the second consecutive year.
• The poverty rate decreased between 2005 and 2006.
• The number of people with health insurance coverage increased between 2005 and 2006, as did the number and the percentage of people without health insurance coverage.
These results were not uniform across demographic groups.
Consumer Integration and Self-Determination in Homelessness Research, Policy, Planning, and Services
In this paper, the authors assess how the process and outcomes of research, policy, and service delivery change when they involve or are driven by people who have themselves experienced homelessness. They review the available evaluation literature and present lessons from the field on consumer integration in research, policy, and program implementation. Barriers to consumer integration and strategies for addressing these barriers are described. Barrow and her colleagues further address what happens when people who are homeless make the decisions about the housing and services they need. They conclude by reviewing findings on the individual- and system-level impacts of consumer-driven approaches to homeless assistance.
The drug strategy covers a ten-year period to 2018, but its delivery is underpinned by a series of three-year action plans. This action plan covers the years 2008-2011.
March 18, 2008
Martha Burt and Brooke Spellman focus on how federal policy and state and local action have stimulated the development of homeless assistance networks and how those networks are evolving to address ending homelessness. While little formal research has been done on this subject, the authors present frameworks for assessing system change as well as describe promising practices from the field. They describe factors that may influence the success of change efforts, including the local and state context, the interest and commitment of stakeholders, the scope of desired change, the governance and management structure for change, and the intended process for change. They also review mechanisms that help make change happen by reorienting local Continuums of Care, matching clients and services, retooling funding approaches, and using data to track implementation and outcomes.
The official poverty rate and the number of people in poverty are important measures of the country’s economic wellbeing. These measures, developed in the 1960s, have been criticized, however, because they do not reflect changes in public policies since then, such as the Earned Income Tax Credit and the use of in-kind benefits such as food stamps. This report explains how the official poverty measure was computed, how several series of alternative estimates were developed, and how the alternative and official measures offer different profiles of people in poverty.
Although Medicaid expenditures for nursing home care are well-documented, little is known about the characteristics of people who use nursing home services. All Medicaid enrollees who reside in nursing homes must meet Medicaid income and asset requirements but pathways to Medicaid eligibility can vary greatly. Some have always had low incomes and are long-term Medicaid enrollees. Others may have met the financial and clinical eligibility criteria for Medicaid after depleting their assets while in a nursing home. Nursing home users can also vary by age, disability status, and other characteristics. As policymakers are considering community-based service programs as alternatives to nursing home care, and debating strategies for securing long-term care insurance for larger subsets of the population, greater knowledge of nursing home utilization in Medicaid--the largest insurer of nursing home care--would provide timely information about those who could potentially benefit from alternative forms of care and new long-term care financing strategies.
We all need a break every now and then that offers the chance to get away from our daily routine. This is the same for you and also for the loved one you care for. You may be nervous about leaving them, but it may do you both good to have a break from one another. If they cannot safely be left alone, ask for another family member or friend to come and stay while you are away. If they need a lot of care or have a specific medical condition, it may be appropriate, following a care assessment, to arrange for a stay in a residential home or hospice for them in order to give you the chance of a holiday. Alternatively, you may wish to arrange a holiday for or with them. Whatever their disability, with prior thought and organisation, a variety of alternatives may be appropriate.
This paper reviews the nature of and responses to homelessness throughout the nation’s history and the evolution of approaches to contemporary homelessness. The author notes that, in the past two decades, a de facto system of service has evolved to apply actions and services to a population experiencing homelessness, through a network of organizations that deliver services within a funding and policy context. He further states, however, that the system is not driven by specific legislation or theory. Instead of a coherent system, different approaches have been adopted by federal departments and the advocacy community. The author’s assessment of progress and future opportunities focuses on the current emphasis on addressing chronic homelessness within the context of the proposed de facto system.
There are two slightly different versions of the federal poverty measure:
- The poverty thresholds, and
- The poverty guidelines.
The poverty thresholds are the original version of the federal poverty measure. They are updated each year by the Census Bureau (although they were originally developed by Mollie Orshansky of the Social Security Administration). The thresholds are used mainly for statistical purposes — for instance, preparing estimates of the number of Americans in poverty each year. (In other words, all official poverty population figures are calculated using the poverty thresholds, not the guidelines.) Poverty thresholds since 1980 and weighted average poverty thresholds since 1959 are available on the Census Bureau’s Web site. . . . The poverty guidelines are the other version of the federal poverty measure. They are issued each year in the Federal Register by the Department of Health and Human Services (HHS). The guidelines are a simplification of the poverty thresholds for use for administrative purposes — for instance, determining financial eligibility for certain federal programs.
Reducing the prevalence of smoking among people in routine and manual groups, some minority ethnic groups and disadvantaged communities will help reduce health inequalities more than any other measure to improve the public's health. Although NHS Stop Smoking Services have helped large numbers of people to quit smoking, smoking cessation rates are still lower among people in routine and manual groups compared with those in higher socioeconomic groups. In particular, pregnant women in routine and manual groups and those aged 20 or under may need additional support to give up smoking. This guidance supersedes 'Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation' (NICE technology appraisal guidance 39). It crossreferences and is consistent with: 'Brief interventions and referral for smoking cessation in primary care and other settings' (NICE public health guidance 1), 'Workplace health promotion: how to help employees to stop smoking' (NICE public health guidance 5) and 'Varenicline for smoking cessation' (NICE technology appraisal guidance 123).
March 17, 2008
Drugs cause considerable harm to society. The Government, working with the police, enforcement agencies and prosecutors, treatment services, children’s services and communities, is determined to tackle the problem. Our shared ambition is to see communities with drug-free streets and our young people and families making drug-free choices.
The authors summarize the progress made in the past decade toward making homeless assistance programs more accountable to funders, consumers, and the public. They observe that research on the costs of homelessness and cost offsets associated with intervention programs has been limited to people who are homeless with severe mental illness. But this research has raised awareness of the value of this approach, such that dozens of new studies in this area are underway, mostly focused on "chronic homelessness." Less progress has been made in using cost and performance data to systematically assess interventions for families, youth, and transitionally homeless adults. The authors present case studies of promising practices from the State of Arizona and Columbus, Ohio, demonstrating innovative uses of client and program data to measure performance and improve program management toward state policy goals, such as increased housing placement rates, reduced lengths of homelessness, and improved housing stability.
The Welfare Indicators Act of 1994 requires the Department of Health and Human Services to prepare annual reports to Congress on indicators and predictors of welfare dependence. The 2007 Indicators of Welfare Dependence, the tenth annual report, provides welfare dependence indicators through 2004, reflecting changes that have taken place since enactment of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in August 1996. As directed by the Welfare Indicators Act, the report focuses on benefits under the Aid to Families with Dependent Children (AFDC) program, now the Temporary Assistance for Needy Families (TANF) program; the Food Stamp Program; and the Supplemental Security Income (SSI) program. Welfare dependence, like poverty, is a continuum, with variations in degree and in duration. Families may be more or less dependent if larger or smaller shares of their total resources are derived from welfare programs. The amount of time over which families depend on welfare might also be considered in assessing their degree of dependence. Although recognizing the difficulties inherent in defining and measuring dependence, a bipartisan Advisory Board on Welfare Indicators proposed that: A family is dependent on welfare if more than 50 percent of its total income in a one-year period comes from AFDC/TANF, food stamps and/or SSI, and this welfare income is not associated with work activities. Given data limitations, we follow the Board’s proposal by adopting the following definition of welfare dependence among individuals in families(1) for use in this report: Welfare dependence is the proportion of all individuals in families that receive more than half of their total family income in one year from TANF, food stamps and/or SSI.
In this paper, the authors synthesize the findings of recent studies examining the role of mainstream programs such as Social Security Administration (SSA) disability programs, Temporary Assistance for Needy Families (TANF), and Workforce Investment Act (WIA) initiatives in enhancing employment and incomes for people who have experienced homelessness. They also describe the design and outcomes of targeted programs designed specifically to address employment and income support for people who are homeless. While some rigorous evaluations have been done on mainstream programs, the effects of the interventions on the subpopulation that has been homeless are often not addressed. Few rigorous studies have been done on targeted programs. The authors draw several conclusions from the available evidence and outline future research directions to fill important gaps in the research literature.
This report analyses ONS Omnibus data for 1996, 2001, 2005 and 2006 and analyses the trends in awareness of the Disability Discrimination Act (DDA) over time. The analysis presented aims to identify people who are likely to be covered by the provisions of the DDA and to demonstrate:
• how awareness of the DDA has changed over time;
• the extent of reported difficulty obtaining goods and services;
• how experience of accessing goods and services has
changed since 1996; and
• the extent to which there is reported difficulty with accessing goods and services relating particularly to accommodation and travel.
Analysis of data across the ten years has indicated significant changes and indications show that there has been good progress in improving the rights of disabled people and removing barriers that they face. Generally there is positive news although there are still areas which could be improved with some groups faring worse than others.
This paper provides an overview of current housing and service models for programs serving people who are homeless and synthesizes the research on the efficacy of each model, what we know about which models work for whom, and the implications for preventing and ending homelessness. The authors begin with background on housing, poverty, and homelessness, including a discussion of changes in the policy and program context within which programs for homeless people operate that have affected housing models since the late 1990s. They then review the recent literature — both descriptions of program models and research on outcomes — focusing first on housing models for families and then on housing models for single individuals with disabilities. Finally, the authors suggest implications for preventing or ending homelessness and directions for future research.
March 14, 2008
The ageing society poses one of our greatest housing challenges. By 2026 older people will account for almost half (48 per cent) of the increase in the total number of households, resulting in 2.4 million more older households than there are today. By 2041 the composition of the older age group will have changed dramatically. There will be a higher proportion of the older age groups, including the over 85s, a greater number of older people from black and minority ethnic groups, and double the number of older disabled people. One in five children born today can expect to live to 100 years old. Today, most of our homes and communities are not designed to meet people’s changing needs as they grow older. Older people’s housing options are too often limited to care homes or sheltered housing. Put simply, we need more and better homes for older people now. This strategy sets out our response to the global challenge of ageing. It also outlines our plans for making sure that there is enough appropriate housing available in future to relieve the forecasted unsustainable pressures on homes, health and social care services.
As discussions on national health care reform move to the forefront, some have focused on the role of immigrants in the health care system, including their impact on the nation’s uninsured problem, their participation in public health coverage programs, and their use of hospital emergency rooms. To address questions about how immigrants use and affect the health care system, this brief draws on available research and data to highlight five key facts about immigrants’ health coverage and care from a national perspective.
This study develops a framework for differentiating true Food Stamp Program (FSP) impacts on food security from those that arise because households with the most severe food-related hardships are more likely to participate in the program. The framework hypothesizes that food spending improvements are the likely causal link between FSP participation and enhanced food security. Since food stamp benefits diminish with income, the incremental effect of FSP participation is also expected to diminish. Using data from the Current Population Survey Food Security Supplements in a statistical framework that controls for household income, the study finds that FSP participants have consistently higher at-home food spending and lower away-from-home-spending than comparable nonparticipants. For both groups, food security rises with income, but food security remains lower for program participants. Because differences in food spending and food security do not disappear as income rises, the study concludes that observed disparities are not likely to be true program impacts.
This guidance sets out how to identify an appropriate consultee for the purposes of section 32 of the Mental Capacity Act. The Act requires the researcher to take reasonable steps to identify a person who, as a result of an existing relationship with the person who lacks capacity, can advise the researcher about that person’s participation in the project. Where no such person can be identified, the Act requires another person who can provide this advice to be appointed in accordance with guidance.
Community empowerment in local governance and service delivery has become a key component of government policy in the UK. However, there are critical challenges to achieving this in practice. This study examined a community-based programme in Wales that aims to increase opportunities for community empowerment and potential influence over service providers.
The Northern Ireland Social Care Council (NISCC), the Regulation and Quality Improvement Authority (RQIA) and the Social Care Institute for Excellence (SCIE) commissioned this research with the aim of strengthening user involvement in Northern Ireland. Report 18 looks across health and social care services for children, young people and adults with four aims:
- To provide a short summary of the history and principles of user involvement.
- To describe the current situation in Northern Ireland.
- To discuss a range of options for the further inclusion and participation of users in the work of NISCC, RQIA and SCIE.
- To make recommendations to inform the development of a future strategy for user
This impact assessment looks at two of the key initiatives outlined in the the National Strategy for Housing in an Ageing Society: a new national housing advice and information service for older people; and the development of new rapid repairs and adaptations services.
The white paper, Care Matters: Time for change, sets out the Government’s commitment to provide an extra £100 per year to the child trust funds of looked after children for every year they spend in care. This consultation seeks views on a guide that sets out the processes that a local authority will need to follow to make sure that every eligible child receives the additional investment in their fund.
March 13, 2008
This consultation provides draft statutory guidance on how local authorities should operate personal education allowances to support the learning and development of looked after children.
This is the eighth edition of Housing Statistics, our annual compendium of statistics covering all aspects of housing in England. In some cases, tables also cover the United Kingdom. Live sets of data tables and charts are available in the Housing Statistics section of this website. There are currently almost 200 of these tables and charts. All of the tables from this annual publication are snapshots from the live sets. We also publish data tables and charts from the annual Survey of English Housing (SEH) as live tables on the Communities and Local Government website.
This report was commissioned by Communities and Local Government as part of a larger project to support the development of the National Strategy for Housing in an Ageing Society. Researchers at the University of York undertook eight focus groups composed of 'younger' older people (aged 48 to 64), and 'older' old people (aged 65 and above) to explore the infl uences on participants' housing decisions, and their future housing intentions and aspirations. The groups were located in different parts of England, including rural, urban and suburban areas. Groups were purposefully recruited to include people who owned their own properties, or were renting from the social and private rented sectors, older people with disabilities, older people from black and minority ethnic (BME) communities, and older lesbian, gay, bisexual and transgender(LGBT) people.
The report first analyzes trends in women’s work experience prior to their first birth and the factors associated with employment during pregnancy. Changes are placed in the historical context of the enactment of family-related legislation during the last quarter of the twentieth century. The next section identifies the maternity leave arrangements used by women before and after their first birth and the shifts that have occurred in the mix of leave arrangements that are used. The final section examines how rapidly mothers return to work after their first birth and the factors related to the length of time they are absent from the labor force. In addition to updating childbearing, employment, and maternity leave trends through the 1990s, the report provides details on changes many new mothers experience in the number of hours worked, pay level, and job skill level after the first birth. These changes are examined in relation to whether a woman returned to the same employer she had during pregnancy or changed employer after the birth of the child.
Maternal and family risks are associated with greater absenteeism and the cumulative exposure to risk best predicts chronic absenteeism in early schooling. Kindergarten children in contact with three or more risks missed three or more days than their peers not facing any risks. But as children progress through the elementary grades, the impact of cumulative risk on school attendance lessens, only to rise again in the fifth grade. The most vulnerable children – those who are poor or racial/ethnic minorities or suffer from poor health–have the greatest exposure to cumulative risk.
We are at a turning point in improving outcomes and experiences for all children and young people with life-limiting and life-threatening conditions, including those with a disability. The findings of the Independent Review of Children’s Palliative Care Services and the cross-government programme Aiming High for Disabled Children are backed by a significant financial commitment. This will help deliver the step change in service provision that is needed for these children, young people and their families, all of whom wish to pursue ordinary lives, achieve their full potential and make a contribution to society.
March 12, 2008
This publication summarises responses to a consultation on the policy behind the new family procedure rules. These rules are intended to modernise the current language, and where possible align the procedures between different levels of court and harmonise the rules for family proceedings with the civil procedure rules.
Bacterial Vaginosis
Chlamydia
Genital Herpes
Genital HPV
Gonorrhea
PID
STDs and Pregnancy
Trichomoniasis
This report looks at mental health and ill health in doctors. It outlines ways in which the NHS can provide appropriate services and encourage doctors and other health care workers to seek early advice and support for mental health problems.
During the last decade, policy and public attention have focused increasingly on the out-of-school hours, and programs to fill this time have proliferated for children and youth. These programs serve varying purposes, including providing child care and a safe haven, improving academic performance, enhancing general youth development, allowing children to explore their interests, and preventing undesirable behaviors. Regardless of the content and structure of programs, parents and children want programs that are engaging and interesting. Defining and measuring quality across diverse programs has been a challenge for the field. However, numerous program quality assessment tools have been developed that can be used for self-assessment and program improvement. This brief identifies some of the advantages of using these tools and suggests a number of quality assessment tools currently available to assess program quality.
In recent years, the central aim of the correctional services has been to reduce re-offending. This role has since been reinforced by the stated aims of National Offender Management Service (NOMS) (Carter, 2003). The correctional services in England and Wales adopted Offending Behaviour Programmes (OBPs) as one of the cornerstones of their rehabilitative work with offenders largely as a result of the ‘what works’ body of research. This work recognised the importance of examining the principles of effective treatment programmes as a basis for interventions to reduce re-offending (Lipsey, 1995; Andrews, Bonta and Hoge, 1990). Key principles of effective correctional interventions identified through this research include risk, need and responsivity (Andrews and Bonta, 1994). Such principles aid the appropriate selection of offenders, design and delivery of interventions. Recent information (Harper and Chitty, 2004) describes that the Prison Service lists 21 fully or provisionally accredited programmes. The Probation Service lists 16 fully or provisionally accredited programmes. Research evidence indicates that the more successful offending behaviour programmes are those drawing from a cognitive behavioural paradigm (McGuire, 1995). Such cognitive skills programmes have a core premise that the thinking skills of an offender, including how they reason and solve problems, is an important factor in their criminal behaviour. The little evidence from cognitive skills programmes in England and Wales in custodial and community settings, has produced mixed findings on effectiveness (Harper and Chitty, 2004).
The child maintenance system is currently going through a period of rapid change. The CSA’s Operational Improvement Plan (OIP) (February 2006), has been introduced to change the way the CSA delivers its services, with a much greater focus on ensuring NRPs fulfil their responsibility to pay maintenance, as well as putting in place more efficient, supportive and responsive processes. . . . The findings of this research report need to be considered in the context of these reforms. The Government’s White Paper acknowledged that the child maintenance system has not lived up to expectations. It is important to note at the outset that some of the proposals contained in the White Paper (in particular the creation of C-MEC), as well as various initiatives within the OIP, should address many of the issues identified by clients within this report. Nevertheless, there are some important insights that should provide a useful focus for both the CSA, and eventually C-MEC, in the delivery of child maintenance.
This document is the report on the consultation on the Mental Capacity Act Nominated Consultee Guidance. It discusses the main points arising from the responses received and the Department's position on these issues.
March 11, 2008
This report presents the findings of a survey of eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and SCHIP for children and families that were implemented or authorized between July 2006 and January 2008 in the 50 states and the District of Columbia. These policies are the driving forces behind efforts to reduce the number of low-income people who lack adequate insurance but cannot afford to pay for it on their own. The survey documents the steps states took to advance coverage, and also the impact of new hurdles that are constraining their efforts to reduce the number of low-income uninsured children, pregnant women and parents.
The recent increase in violent crime defies easy explanation, and many hypotheses have been put forward for debate. In this brief, we propose that the rise in violent offending and the explosion in the sales of iPods and other portable media devices is more than coincidental. We propose that, over the past two years, America may have experienced an iCrime wave.
Late-stage trials designed to evaluate biomedical interventions should incorporate randomized comparisons of behavioral interventions when possible. Other important design recommendations include: using endpoint-driven trials; considering inclusion of both blinded and unblinded control arms in future trials; collecting information for evaluating the effects of biomedical interventions on women who become pregnant during a trial and their fetuses; and selecting methods for evaluating product adherence and risk-taking behavior. Key recommendations for conducting late-stage HIV prevention trials include monitoring the evolving results of a trial to ensure that it is maintaining the best interests of participants, adjusting the trial to improve adherence or other aspects of the study protocol, and using safety information that may become available from external sources. Recommendations for analyzing trial results include using participant adherence in evaluating the relationship between interventions and HIV risk; the practice of excluding results from participants judged to have been already infected at the time of enrollment, and accounting for product discontinuation due to pregnancy in the analysis of the risk of HIV infection. Finally, in order to enable more efficient evaluations of biomedical interventions, the committee recommends that researchers give priority to developing biomarkers of recent HIV infection which can be used in cross-sectional samples to estimate HIV incidence rates, identifying surrogate markers for HIV infection and product activity that investigators can reliably use as intermediate trial endpoints, andexploring alternative trial designs that might answer important research questions more efficiently than
the traditional two-arm superiority design.
End of Life: Helping With Comfort and Care hopes to make the unfamiliar territory of death slightly more comfortable for everyone involved. This publication is based on research, such as that supported by the National Institute on Aging, part of the National Institutes of Health. This research base is augmented with suggestions from practitioners with expertise in helping individuals and families through this difficult time. Throughout the booklet, the terms comfort care, supportive care, and palliative care are used to describe individualized care that can provide a dying person the best quality of life until the end. Most of the stories in this booklet are fictitious, but they depict situations that reflect common experiences at the end of life. When a doctor says something like, “I’m afraid the news is not good. There are no other treatments for us to try. I’m sorry,” it may close the door to the possibility of a cure, but it does not end the need for medical support. Nor does it end the involvement of family and friends.
The money trail in children’s behavioral health leads to strange and unexpected places. In a time of more and more information about effective practice and historically high levels of child behavioral health funding, it leads to community-level service shortages and poor quality combined with inadequate mechanisms for accountability. It leads to fiscal policy that is out of sync with the knowledge base on effective practices, with opportune times to intervene and with strategies that lead to improved mental health for children and youth. On occasion it leads to pockets of service excellence. Following the money in children’s behavioral health also shows that opportunities abound for improving service quality-informed fiscal policy.
This booklet outlines why those working with women prisoners should pay particular attention to their housing needs and offers support in seeking to maintain and gain housing on discharge from custody. Much of the effort of housing advisers and other staff is spent on finding new housing on discharge. In an environment where housing is becoming harder and harder to access it makes sense to try to preserve the housing that many women have when they are received into prison. This briefing focuses on those in rented accommodation.
March 10, 2008
This guide has been designed for people who want to make a difference and improve standards of dignity in care. It provides information for service users on what they can expect from health and social care services, and a wealth of resources and practical guidance to help service providers and practitioners in developing their practice, with the aim of ensuring that all people who receive health and social care services are treated with dignity and respect. Whether you only have five minutes to get some quick ideas, or five hours to gain an in-depth understanding, this guide should meet your needs.
The purpose of this Issue Brief is to (1) briefly review past efforts by employers to curb rising costs in health benefit coverage and care, (2) help shed light on consumer values and how (and why) consumers make the health-related decisions they do, and (3) describe and discuss values-based, patient-centered approaches being taken in some hospital and other health care settings, and (4) present the case for valuesfocused employee education in health benefits and care.
HIV/AIDS prevention services were generally available from IHS, but these services varied across the 12 IHS areas. HIV/AIDS education was provided in all areas in a variety of settings, such as IHS-funded facilities, schools, and health fairs. In addition to education, IHS offered HIV testing services in all areas; however, the type and extent of services varied. In addition, some IHS officials described other services that were provided as part of their HIV/AIDS prevention activities, such as condom distribution. According to IHS officials, HIV/AIDS treatment services, while offered at some IHS facilities, were generally received outside of IHS. Five IHS-funded hospitals, such as the Phoenix Indian Medical Center in Arizona, regularly treated patients. Although some other IHS facilities provided limited treatment services, most relied on outside providers. For example, IHS patients with HIV/AIDS might see a specialist outside of IHS every 3 months for their HIV/AIDS treatment services and an IHS provider for other routine care. IHS officials reported that most IHS facilities did not provide treatment services because they had few American Indian or Alaska Native patients known to have HIV/AIDS, had limited resources, focused on other health concerns, or their providers had limited training or experience treating the disease. Additionally, some patients may not access or continue treatment from IHS or outside providers due to concerns about confidentiality and lack of transportation to distant facilities.
This report describes the methods, applications, and value for policymakers of systematic reviews that evaluate interventions intended to improve population health. These reviews are the best available scientific guidance for choosing among alternative policies. Systematic reviews apply the methods of research (sometimes called “evidence”) synthesis, a rapidly developing area of inquiry that merges the biomedical and social sciences. Policymakers and scientists collaborated in planning this report. They also reviewed it in draft, giving particular attention to its accuracy, balance, and accessibility. These colleagues,