Science.gov

Sample records for state payer mandates

  1. The value of all-payer claims databases to states.

    PubMed

    Peters, Ashley; Sachs, Jane; Porter, Jo; Love, Denise; Costello, Amy

    2014-01-01

    All-payer claims databases are being developed in states across the nation to fill gaps in information about the health care system. The value of such databases is becoming more apparent as these databases mature and are used more frequently to help states better understand their health care utilization and costs. PMID:24830498

  2. Mandated State-Level Open Government Training Programs

    ERIC Educational Resources Information Center

    Kimball, Michele Bush

    2011-01-01

    Although every state in the country has recognized the importance of government transparency by enacting open government provisions, few of those statutes require training programs to encourage records custodians to comply with the law. Ten states mandate training in how to legally respond to public records requests, and some mandates are stronger…

  3. THE EFFECT OF STATE INSURANCE MANDATES ON INFANT IMMUNIZATION RATES.

    PubMed

    Chang, Lenisa V

    2016-03-01

    While US infant immunization rates have been increasing in the last 20 years, the cost of fully immunizing a child with all recommended vaccines has almost tripled. This is partly not only due to new additions in the list of recommended vaccines but also due to the use of new, safer, but more expensive technologies in vaccine production and distribution. In recent years, many states have mandated that recommended childhood vaccines be covered by private health insurance companies. Currently, there are 33 states with such a mandate. In this paper, I examine whether the introduction of mandates on private insurers affected immunization rates. Using state and time variation, I find that mandates increased the immunization rate for three vaccines--the diphtheria-tetanus-pertussis, polio, and measles-mumps-rubella vaccines--by about 1.8 percentage points. These results may provide a lower bound for the expected effect of the Affordable Care Act, which mandates coverage of childhood vaccines for all private insurers in the USA. I also find evidence that the mandates shifted a significant portion of vaccinations from publicly funded sources to private ones, with a decline in public health clinic visits and an increase in vaccinations at hospitals and doctor's offices. PMID:25773053

  4. Certified School Nurse Perspectives on State-Mandated Hearing Screens

    ERIC Educational Resources Information Center

    Sekhar, Deepa L.; Beiler, Jessica S.; Schaefer, Eric W.; Henning, Antoinette; Dillon, Judith F.; Czarnecki, Beth; Zalewski, Thomas R.

    2016-01-01

    Background: Approximately 15% of children in the United States 6-19 years of age have hearing loss. Even mild, unilateral hearing loss may adversely affect educational success. In 2014, the Pennsylvania Department of Health (PA DOH) began updating the 2001 regulations on state-mandated school hearing screens. To inform the updates, a needs…

  5. Biosimilar competition in the United States: statutory incentives, payers, and pharmacy benefit managers.

    PubMed

    Falit, Benjamin P; Singh, Surya C; Brennan, Troyen A

    2015-02-01

    Widespread adoption of generic medications, made possible by the Hatch-Waxman Act of 1984, has contained the cost of small-molecule drugs in the United States. Biologics, however, have yet to face competition from follow-on products and represent the fastest-growing sector of the US pharmaceutical market. We compare the legislative framework governing small-molecule generics to that which regulates follow-on biologics, and we examine management tools that are likely to be most successful in promoting biosimilars' adoption. The Biologics Price Competition and Innovation Act established an abbreviated pathway for follow-on biologics, but weak statutory incentives create barriers to entry. Many authors have raised concerns that competition under the biologics act may be weaker than that posed by small-molecule generics under Hatch-Waxman, in part because of legislative choices such as the absence of market exclusivity for the first biosimilar approved and a requirement that follow-on manufacturers disclose their manufacturing processes to the manufacturer of the reference product. Provider skepticism and limited competition from biosimilars will challenge payers and pharmacy benefit managers to reduce prices and maximize uptake of follow-on biologics. Successful payers and pharmacy benefit managers will employ various strategies, including tiered formularies and innovative fee schedules, that can control spending by promoting uptake of biosimilars across both the pharmacy and medical benefits. PMID:25646110

  6. Colorectal Cancer Screening and State Health Insurance Mandates.

    PubMed

    Hamman, Mary K; Kapinos, Kandice A

    2016-02-01

    Colorectal cancer (CRC) is the third most deadly cancer in the USA. CRC screening is the most effective way to prevent CRC death, but compliance with recommended screenings is very low. In this study, we investigate whether CRC screening behavior changed under state mandated private insurance coverage of CRC screening in a sample of insured adults from the 1997 to 2008 Behavioral Risk Factor Surveillance Survey (BRFSS). We present difference-in-difference-in-differences (DDD) estimates that compare insured individuals age 51 to 64 to Medicare age-eligible individuals (ages 66 to 75) in mandate and non-mandate states over time. Our DDD estimates suggest endoscopic screening among men increased by 2 to 3 percentage points under mandated coverage among 51 to 64 year olds relative to their Medicare age-eligible counterparts. We find no clear evidence of changes in screening behavior among women. DD estimates suggest no evidence of a mandate effect on either type of CRC screening for men or women. PMID:25521438

  7. State-Mandated Economic Education, Teacher Attitudes, and Student Learning.

    ERIC Educational Resources Information Center

    Marlin, James W., Jr.

    1991-01-01

    Investigates factors affecting teacher attitudes and the resultant impact on student learning. Uses data from a 1987 National Assessment of Economic Education (NAEE) survey. Finds that state-mandated economics courses cause a decrease in teacher enthusiasm but that training in how to teach economics increases teacher enthusiasm and has a positive…

  8. Retention as a State Policy Mandate: IREAD in Indiana

    ERIC Educational Resources Information Center

    Stubbs, Velinda F.

    2013-01-01

    The interpretation of Indiana Public Law 109 and subsequent policy adopted by the Indiana Department of Education resulted in the Indiana State Board of Education mandating circumstances implemented during the 2011-2012 school year regarding grade level retention of Grade 3 students. IREAD-3, a standardized, gateway assessment, was administered to…

  9. Do States Have the Capacity to Meet the NCLB Mandates?

    ERIC Educational Resources Information Center

    Sunderman, Gail L.; Orfield, Gary

    2007-01-01

    The states have always been central to the American public school systems, and they have been sharply expanding their authority over local school districts since the 1980s, when they adopted education reforms that increased course requirements (especially in science and math), mandated uniform testing, and put in place higher teaching standards. A…

  10. Lessons from state mandates of preventive cancer screenings.

    PubMed

    Xu, Wendy Yi; Dowd, Bryan; Abraham, Jean

    2016-03-01

    We use the 1997-2008 Medical Expenditure Panel Survey (MEPS) and variation in the timing of state mandates for coverage of colorectal, cervical, and prostate cancer screenings to investigate the behavioral and financial effects of mandates on privately insured adults. We find that state mandates did not result in increased rates of cancer screening. However, coverage of preventive care, whether mandated or not, moves the cost of care from the consumer's out-of-pocket expense to the premium, resulting in a cross-subsidy of users of the service by non-users. While some cross-subsidies are intentional, others may be unintentional. We find that users of cancer screening have higher levels of income and education, while non-users tend to be racial minorities, lack a usual source of care, and live in communities with fewer physicians per capita. These results suggest that coverage of preventive care may transfer resources from more advantaged individuals to less advantaged individuals. PMID:25773049

  11. The Little State That Couldn't Could? The Politics of "Single-Payer" Health Coverage in Vermont.

    PubMed

    Fox, Ashley M; Blanchet, Nathan J

    2015-06-01

    In May 2011, a year after the passage of the Affordable Care Act (ACA), Vermont became the first state to lay the groundwork for a single-payer health care system, known as Green Mountain Care. What can other states learn from the Vermont experience? This article summarizes the findings from interviews with nearly 120 stakeholders as part of a study to inform the design of the health reform legislation. Comparing Vermont's failed effort to adopt single-payer legislation in 1994 to present efforts, we find that Vermont faced similar challenges but greater opportunities in 2010 that enabled reform. A closely contested gubernatorial election and a progressive social movement opened a window of opportunity to advance legislation to design three comprehensive health reform options for legislative consideration. With a unified Democratic government under the leadership of a single-payer proponent, a high-profile policy proposal, and relatively weak opposition, a framework for a single-payer system was adopted by the legislature - though with many details and political battles to be fought in the future. Other states looking to reform their health systems more comprehensively than national reform can learn from Vermont's design and political strategy. PMID:25700374

  12. Why the United States should adopt a single-payer system of health care finance.

    PubMed

    DeGrazia, D

    1996-06-01

    Although nothing could be less fashionable today than talk of comprehensive health care reform, the major problems of American health care have not gone away. Only a radical change in the way the U.S. finances health care--specifically, a single-payer system--will permit the achievement of universal coverage while keeping costs reasonably under control. Evidence from other countries, especially Canada, suggests the promise of this approach. In defending the single-payer approach, the author identifies several political and cultural factors that make it difficult for Americans to obtain a clear view of this option. Finally, the author argues that much discussion of rationing is vitiated by bracketing more systemic questions to which the issue of rationing is inextricably linked. PMID:10158031

  13. How Schools Are Meeting State Legal Mandates to Provide Online Education

    ERIC Educational Resources Information Center

    Deschaine, Mark Edward

    2013-01-01

    This study explores how public schools in Michigan are meeting the mandate to provide online learning opportunities as a condition of graduation. Michigan became the first state in the nation to mandate online learning opportunities as a condition for graduation with the passage of the Michigan Merit Curriculum. Although the mandate for compliance…

  14. State law mandates for reporting of healthcare-associated Clostridium difficile infections in hospitals.

    PubMed

    Reagan, Julie; Herzig, Carolyn T A; Pogorzelska-Maziarz, Monika; Dick, Andrew W; Stone, Patricia W; Divya Srinath, Jd

    2015-03-01

    US state and territorial laws were reviewed to identify Clostridium difficile infection reporting mandates. Twenty states require reporting either under state law or by incorporating federal Centers for Medicare & Medicaid Services' reporting requirements. Although state law mandates are more common, the incorporation of federal reporting requirements has been increasing. PMID:25695178

  15. Effectiveness of state-level vaccination mandates: evidence from the varicella vaccine.

    PubMed

    Abrevaya, Jason; Mulligan, Karen

    2011-09-01

    This paper utilizes longitudinal data on varicella (chickenpox) immunizations in order to estimate the causal effects of state-level school-entry and daycare-entry immunization mandates within the United States. We find significant causal effects of mandates upon vaccination rates among preschool children aged 19-35 months; these effects appear in the year of mandate adoption, peak two years after adoption, and show a minimal difference from the aggregate trend about six years after adoption. For a mandate enacted in 2000, the model and estimates imply that roughly 20% of the short-run increase in state-level immunization rates was caused by the mandate introduction. We find no evidence of differential effects for different socioeconomic groups. Combined with previous cost-benefit analyses of the varicella vaccine, the estimates suggest that state-level mandates have been effective from an economic standpoint. PMID:21715035

  16. State-mandated insurance coverage is associated with the approach to hydrosalpinges before IVF

    PubMed Central

    Omurtag, Kenan; Grindler, Natalia M.; Roehl, Kimberly A.; Bates, G. Wright; Beltsos, Angeline N.; Odem, Randall R.; Jungheim, Emily S.

    2014-01-01

    The aim of this study was to determine whether practice in states with infertility insurance mandates is associated with physician-reported practice patterns regarding hydrosalpinx management in assisted reproduction clinics. A cross-sectional, internet-based survey of 442 members of Society for Reproductive Endocrinology and Infertility or Society of Reproductive Surgeons was performed. Physicians practising in states without infertility insurance mandates were more likely to report performing diagnostic surgery after an inconclusive hysterosalpingogram than physicians practising in states with mandates (RR 1.2, 95% CI 1.1–1.3, P < 0.01). Additionally, respondents in states without mandates were more likely to report that, due to lack of infertility insurance coverage, they did not perform salpingectomy (SPX) or proximal tubal occlusion (PTO) before assisted reproduction treatment (RR 1.4, 95% CI 1.1–1.8, P = 0.01). Finally, respondents in states without mandates were less likely to report that the presence of assisted reproduction treatment coverage determined the urgency with which they pursued SPX or PTO before treatment (RR 0.7, 95% CI 0.5–1.0, NS). These results persisted after controlling for physician years in practice, age and clinic volume. In conclusion, self-reported physician practice interventions for hydrosalpinges before assisted reproduction treatment may be associated with state-mandated infertility insurance. PMID:24813751

  17. US state variation in autism insurance mandates: balancing access and fairness.

    PubMed

    Johnson, Rebecca A; Danis, Marion; Hafner-Eaton, Chris

    2014-10-01

    This article examines how nations split decision-making about health services between federal and sub-federal levels, creating variation between states or provinces. When is this variation ethically acceptable? We identify three sources of ethical acceptability-procedural fairness, value pluralism, and substantive fairness-and examine these sources with respect to a case study: the fact that only 30 out of 51 US states or territories passed mandates requiring private insurers to offer extensive coverage of autism behavioral therapies, creating variation for privately insured children living in different US states. Is this variation ethically acceptable? To address this question, we need to analyze whether mandates go to more or less needy states and whether the mandates reflect value pluralism between states regarding government's role in health care. Using time-series logistic regressions and data from National Survey of Children with Special Health Care Needs, Individual with Disabilities Education Act, legislature political composition, and American Board of Pediatrics workforce data, we find that the states in which mandates are passed are less needy than states in which mandates have not been passed, what we call a cumulative advantage outcome that increases between-state disparities rather than a compensatory outcome that decreases between-state disparities. Concluding, we discuss the implications of our analysis for broader discussions of variation in health services provision. PMID:24789870

  18. Is State-Mandated Redesign an Effective and Sustainable Solution?

    ERIC Educational Resources Information Center

    Young, Michelle D.

    2013-01-01

    There is a pervasive and ongoing perception that leadership preparation is a problem. Important questions remain about the intentions, capacity, and impact of state departments of education engaged in leadership preparation program redesign. In this essay, I take up several issues concerning this state policy work, including whether a one size…

  19. Implementing Curricular Change through State-Mandated Testing: Ethical Issues.

    ERIC Educational Resources Information Center

    Mathison, Sandra

    1991-01-01

    Explores the ethical issues involved in using standardized tests to implement a state-level policy. Examines the fourth grade science program evaluation test administered in New York State for the first time in 1989. A utilitarian view of ethics ignores the consequences of testing for different constituents, obviates caring behavior, and damages…

  20. States Stepping up Mandates for School Safety Drills

    ERIC Educational Resources Information Center

    Shah, Nirvi

    2013-01-01

    Hundreds of U.S. schools will supplement fire drills and tornado training next fall with simulations of school shootings. In response to the December shootings by an intruder at Sandy Hook Elementary School in Newtown, Connecticut, several states have enacted or are considering laws that require more and new types of school safety drills, more…

  1. The Financial Education Tool Kit: Helping Teachers Meet State- Mandated Personal Finance Requirements

    ERIC Educational Resources Information Center

    St. Pierre, Eileen; Richert, Charlotte; Routh, Susan; Lockwood, Rachel; Simpson, Mickey

    2012-01-01

    States are recognizing the need for personal financial education and have begun requiring it as a condition for high school graduation. Responding to teacher requests to help them meet state-mandated financial education requirements, FCS educators in the Oklahoma Cooperative Extension Service developed a financial education tool kit. This article…

  2. Linking Scholarship and Practice: Community College Leaders, State Mandates, and Leadership Competencies

    ERIC Educational Resources Information Center

    Hebert-Swartzer, Cathleen A.; McNair, Delores E.

    2010-01-01

    To be an effective leader in today's community college requires a sophisticated set of skills that are often learned through on the job training, mentoring, and professional development activities. Using case study methodology, this study examined how community college leaders in California use their skills to implement a state mandate related to…

  3. State-Mandated Principal Preparation Program Redesign: Impetus for Reform or Invitation to Chaos?

    ERIC Educational Resources Information Center

    Phillips, Joy C.

    2013-01-01

    Increasing criticism of practicing educational leaders has led to additional critiques of the university programs in which they are prepared. In response, many states have mandated statewide university preparation program redesign. The articles in this special issue describe five unique cases of principal preparation program redesign--including…

  4. Dangerous Liaisons: Reflections on a Pilot Project for State-Mandated Outcomes Assessment of Written Communication

    ERIC Educational Resources Information Center

    Denny, Harry C.

    2008-01-01

    This study details the development and results of a campus-based writing assessment plan that was mandated by a state-wide university system in order to explore the ''value-added'' from a writing program curriculum to undergraduate students' competence with written expression. Four writing samples (two timed essays and two conventional essays)…

  5. Evaluation of Alabama Public School Wellness Policies and State School Mandate Implementation

    ERIC Educational Resources Information Center

    Gaines, Alisha B.; Lonis-Shumate, Steven R.; Gropper, Sareen S.

    2011-01-01

    Background: This study evaluated wellness policies created by Alabama public school districts and progress made in the implementation of Alabama State Department of Education (ALSDE) school food and nutrition mandates. Methods: Wellness policies from Alabama public school districts were compared to minimum requirements under the Child Nutrition…

  6. The Relationship of State Funding of Education to Student Performance on State Mandated Assessments in South Dakota

    ERIC Educational Resources Information Center

    Price, Joel Philip

    2012-01-01

    This study determined the relationship of state funding to student performance on state mandated assessments in South Dakota between the years of 2003-2009. A cohort group of 40 school districts between 200 ADM and 600 ADM who had not reorganized were selected. Data was collected using the Dakota STEP assessment portal on the South Dakota…

  7. Continuously Uncertain Reform Effort: State-Mandated History and Social Science Curriculum and the Perceptions of Teachers

    ERIC Educational Resources Information Center

    Martell, Christopher

    2010-01-01

    This study examined teachers' attitudes and beliefs in one over-performing urban/suburban high school of the state-mandated curriculum framework under conditions that I label a continuously uncertain reform effort or a top-down mandated curriculum involving constant mixed-messages as to its content, accountability demands, and future existence.…

  8. State-mandated reporting of health care-associated infections in the United States: trends over time.

    PubMed

    Herzig, Carolyn T A; Reagan, Julie; Pogorzelska-Maziarz, Monika; Srinath, Divya; Stone, Patricia W

    2015-01-01

    Over the past decade, most US states and territories began mandating that acute care hospitals report health care-associated infections (HAIs) to their departments of health. Trends in state HAI law enactment and data submission requirements were determined through systematic legal review; state HAI coordinators were contacted to confirm collected data. As of January 31, 2013, 37 US states and territories (71%) had adopted laws requiring HAI data submission, most of which were enacted and became effective in 2006 and 2007. Most states with HAI laws required reporting of central line-associated bloodstream infections in adult intensive care units (92%), and about half required reporting of methicillin-resistant Staphylococcus aureus and Clostridium difficile infections (54% and 51%, respectively). Overall, data submission requirements were found to vary across states. Considering the facility and state resources needed to comply with HAI reporting mandates, future studies should focus on whether these laws have had the desired impact of reducing infection rates. PMID:24951104

  9. Do Fourteenth Amendment considerations outweigh a potential state interest in mandating cochlear implantation for deaf children?

    PubMed

    Bender, Denise G

    2004-01-01

    Currently, the decision concerning pediatric cochlear implantation for children remains a personal choice for parents to make. Economic factors, educational outcomes, and societal attitudes concerning deafness could result in an increased governmental interest in this choice. This article examines case law related to the issue of parental autonomy to determine whether the state, acting in the role of parens patriae, could use economic and social reasons to mandate the provision of cochlear implants for all eligible children. The author uses previous cases as a framework to develop an opinion on whether a constitutional protection for parents may exist. PMID:15304405

  10. New evidence on hospital profitability by payer group and the effects of payer generosity.

    PubMed

    Friedman, Bernard; Sood, Neeraj; Engstrom, Kelly; McKenzie, Diane

    2004-09-01

    This study provides (a) new estimates of U.S. hospital profitability by payer group, controlling for hospital characteristics, and (b) evidence about the intensity of care for particular diseases associated with the generosity of the patient's payer and other payers at the same hospital. The conceptual framework is a variant of the well-known model of a local monopolist selling in a segmented market. Effects of two kinds of regulation are considered. The data are taken from hospital accounting reports in four states in FY2000, and detailed discharge summaries from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. The profitability of inpatient care for privately insured patients was found to be about 4% less than for Medicare, but 14% higher than for Medicaid and only 9% higher than for self-pay patients. We found significant direct associations but not external effects of payer generosity on the intensity of care. PMID:15277780

  11. Are payers treating orphan drugs differently?

    PubMed Central

    Cohen, Joshua P.; Felix, Abigail

    2014-01-01

    Background Some orphan drugs can cost hundreds of thousands of dollars annually per patient. As a result, payer sensitivity to the cost of orphan drugs is rising, particularly in light of increased numbers of new launches in recent years. In this article, we examine payer coverage in the United States, England and Wales, and the Netherlands of outpatient orphan drugs approved between 1983 and 2012, as well as the 11 most expensive orphan drugs. Methods We collected data from drug regulatory agencies as well as payers and drug evaluation authorities. Results We found that orphan drugs have more coverage restrictions than non-orphan drugs in all three jurisdictions. From an economic perspective, the fact that a drug is an orphan product or has a high per-unit price per se should not imply a special kind of evaluation by payers, or necessarily the imposition of more coverage restrictions. Conclusion Payers should consider the same set of decision criteria that they do with respect to non-orphan drugs: disease severity, availability of treatment alternatives, level of unmet medical need, and cost-effectiveness, criteria that justifiably may be taken into account and traded off against one another in prescribing and reimbursement decisions for orphan drugs.

  12. Improving coordinated responses for victims of intimate partner violence: law enforcement compliance with state-mandated intimate partner violence documentation.

    PubMed

    Cerulli, Catherine; Edwardsen, Elizabeth A; Hall, Dale; Chan, Ko Ling; Conner, Kenneth R

    2015-07-01

    New York State law mandates specific intimate partner violence (IPV) documentation under all circumstances meeting the enumerated relationship and crime criteria at the scene of a domestic dispute. Law enforcement compliance with this mandate is unknown. We reviewed law enforcement completion rates of Domestic Violence Incident Reports (DVIRs) and assessed correlations with individual or legal factors. Law enforcement officers filed DVIRs in 54% of the cases (n = 191), more often when injury occurred (p < .01) and the defendant had prior court contact (p < .05). The discussion explores policy implications and potential means to rectify the gap between mandated processes and implementation. PMID:25926052

  13. IMPROVING COORDINATED RESPONSES FOR VICTIMS OF INTIMATE PARTNER VIOLENCE: LAW ENFORCEMENT COMPLIANCE WITH STATE MANDATED INTIMATE PARTNER VIOLENCE DOCUMENTATION

    PubMed Central

    Cerulli, Catherine; Edwardsen, Elizabeth A.; Hall, Dale; Chan, Ko Ling; Conner, Kenneth R.

    2015-01-01

    New York State law mandates specific IPV documentation under all circumstances meeting the enumerated relationship and crime criteria at the scene of a domestic dispute. Law enforcement compliance with this mandate is unknown. We reviewed law enforcement completion rates of Domestic Violence Incident Reports (DVIRs) and assessed correlations with individual or legal factors. Law enforcement officers filed DVIRs in 54% of the cases (n=191), more often when injury occurred (p<.01) and the defendant had prior court contact (p<.05). The discussion explores policy implications and potential means to rectify the gap between mandated processes and implementation. PMID:25926052

  14. Back on the Backburner? Impact of Reducing State-Mandated Social Studies Testing on Elementary Teachers' Instruction

    ERIC Educational Resources Information Center

    Vogler, Kenneth E.

    2011-01-01

    Numerous studies have shown how elementary social studies instruction has been constrained or curtailed in states that do not test social studies as part of their mandated accountability system. South Carolina is a state that tests social studies as well as English, mathematics, and science in grades three through eight as part of its…

  15. West Virginia Physical Education Teacher Perceptions of State Mandated Fitnessgram® Testing and Application of Results

    ERIC Educational Resources Information Center

    Miller, William M.

    2013-01-01

    Background/Purpose: In response to concerns with increasing rates of childhood obesity, many states have enacted policies that affect physical education. A commonly used approach is state mandated fitness test administration in school-based settings. While this approach is widely debated throughout the literature, one area that lacks research is…

  16. Caught in the Current: A Self-Study of State-Mandated Compliance in a Teacher Education Program

    ERIC Educational Resources Information Center

    Kornfeld, John; Grady, Karen; Marker, Perry M.; Ruddell, Martha Rapp

    2007-01-01

    Background/Context: The nationwide preoccupation with accountability continues to grow, with teacher credentialing programs facing growing scrutiny through state-mandated accountability systems. In response to Senate Bill 2042 passed by the California state legislature in 1998, the California Commission for Teacher Credentialing (CCTC) established…

  17. Managing benefits for diabetes: changing payer strategies for changing times.

    PubMed

    Tzeel, Albert

    2013-01-01

    Just as there are many ways to treat a condition such as diabetes, there are also many ways for payers to manage the diabetes benefit. Although none of these methods is specifically right or wrong, they are grounded in a payer's philosophy and created in response to the needs of the time. Yet, just as in any other business, new ideas and, for diabetes, new scientific discoveries will surely mandate new strategies to achieve goals. As payers find themselves adapting to new political realities and new partnerships, one cannot be sure if their new strategies will succeed or not. But, in actuality, this becomes moot as the 1 point we can be sure of is that benefit management will continue to evolve. PMID:23725238

  18. State-mandated school-based BMI screening and parent notification: a descriptive case study.

    PubMed

    Kaczmarski, Jenna M; DeBate, Rita D; Marhefka, Stephanie L; Daley, Ellen M

    2011-11-01

    To address childhood obesity, several states and local school districts across the United States have adopted body mass index (BMI) measurement initiatives. This descriptive case study explored psychosocial, environmental, and behavioral factors among parents of sixth-grade students who received BMI Health Letters (BMIHLs) in one Florida County. A nonexperimental postintervention design was employed to gather quantitative data via self-report Likert-type questionnaire. Participants were parents/guardians of sixth-grade students attending one Hillsborough County public middle school (n = 76). Results indicate three main findings: (a) most parents in this study (67.4%) who discussed the BMIHL with their child reported their child as "very" or "somewhat" uncomfortable with the discussion; (b) some parents of normal weight (NW) children responded by taking their child to a medical professional to control their weight; and (c) more parents of at risk of overweight/overweight (AR/OW) children (vs. NW) reported greater concern about their child's weight, using food restriction and physical activity to control their child's weight, and giving negative weight-related comments/behaviors. This case study illustrates the importance of adapting and tailoring state mandated BMIHLs for parents based on child's BMI status. PMID:22068272

  19. Using General Outcome Measures to Predict Student Performance on State-Mandated Assessments: An Applied Approach for Establishing Predictive Cutscores

    ERIC Educational Resources Information Center

    Leblanc, Michael; Dufore, Emily; McDougal, James

    2012-01-01

    Cutscores for reading and math (general outcome measures) to predict passage on New York state-mandated assessments were created by using a freely available Excel workbook. The authors used linear regression to create the cutscores and diagnostic indicators were provided. A rationale and procedure for using this method is outlined. This method…

  20. Negotiating Dual Accountability Systems: Strategic Responses of Big Picture Schools to State-Mandated Standards and Assessment

    ERIC Educational Resources Information Center

    Suchman, Sara P.

    2012-01-01

    The No Child Left Behind Act of 2001 mandated that states implement standards and test-based accountability systems. In theory, local educators are free to select the means for teaching the standards so long as students achieve a predetermined proficiency level on the exams. What is unclear, however, is how this theory plays out in schools…

  1. Has the Shift to Managed Care Reduced Medicaid Expenditures? Evidence from State and Local-Level Mandates

    ERIC Educational Resources Information Center

    Duggan, Mark; Hayford, Tamara

    2013-01-01

    From 1991 to 2009, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 71 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan. Theoretically, it is ambiguous whether the shift from…

  2. A Reflection on Lessons Learned from Implementation of a State-Mandated Co-Teaching Model for Student Teaching

    ERIC Educational Resources Information Center

    Willis, Dottie

    2015-01-01

    The author reflects on challenges faced by teacher educators when Kentucky's Educational Professional Standards Board mandated a new Co-Teaching model for all of the state's student teachers in 2013. This article analyzes the overwhelmingly positive responses of cooperating teachers and the experiences of teacher candidates (student teachers) with…

  3. A Retrospective Cohort Comparison of Career and Technical Education Participants and Non-Participants on a State-Mandated Proficiency Test

    ERIC Educational Resources Information Center

    Bae, Sang Hoon; Gray, Kenneth; Yeager, Georgia

    2007-01-01

    The sometimes poor performance of Career and Technical Education (CTE) concentrators on a state-mandated proficiency test is a major concern of CTE educators. This study examined whether (a) there are performance differences on state-mandated 11th-grade math and reading tests between CTE and non-CTE students with similar proficiency scores in the…

  4. Do biofuel blending mandates reduce gasoline consumption? Implications of state-level renewable fuel standards for energy security

    NASA Astrophysics Data System (ADS)

    Lim, Shinling

    In an effort to keep America's addiction to oil under control, federal and state governments have implemented a variety of policy measures including those that determine the composition of motor gasoline sold at the pump. Biofuel blending mandates known as Renewable Fuel Standards (RFS) are designed to reduce the amount of foreign crude oil needed to be imported as well as to boost the local ethanol and corn industry. Yet beyond looking at changes in gasoline prices associated with increased ethanol production, there have been no empirical studies that examine effects of state-level RFS implementation on gasoline consumption. I estimate a Generalized Least Squares model for the gasoline demand for the 1993 to 2010 period with state and time fixed effects controlling for RFS. States with active RFS are Minnesota, Hawaii, Missouri, Florida, Washington, and Oregon. I find that, despite the onset of federal biofuel mandates across states in 2007 and the lower energy content of blended gasoline, being in a state that has implemented RFS is associated with 1.5% decrease in gasoline consumption (including blended gasoline). This is encouraging evidence for efforts to lessen dependence on gasoline and has positive implications for energy security.

  5. Mandated Testing: Lived Situations.

    ERIC Educational Resources Information Center

    Phillips, Jerry; Phillips, Julie

    This paper describes a father's reflections on his daughter Charlie's failure to pass a state-mandated standardized test; reactions of both to the failure; reactions of both to emerging events; Charlie's next challenge and her looking to the future, and final thoughts and conclusions. The paper is a collaborative effort between father and daughter…

  6. Can ship-to-classroom interactions aid in teaching state-mandated curricula to special needs students?

    NASA Astrophysics Data System (ADS)

    Haddad, A.; Turner, M.; Samuelson, L.; Scientific Team of IODP Expedition 336: Mid-Atlantic Ridge Microbiology

    2011-12-01

    Cutting edge science is so exciting to elementary-level students with special needs that they are constantly asking for more! We drew on this enthusiasm and developed an interaction between special needs students and scientists performing cutting edge research on and below the ocean floor with the goal of teaching them state-mandated curricula. While on board the JOIDES Resolution during IODP Expedition 336: Mid-Atlantic Ridge Microbiology (Fall 2011), scientists interacted with several special needs classrooms in the Phoenix, Arizona metro area via weekly activities, blogs, question-and-answer sessions and Skype calls revolving around ocean exploration. All interactions were developed to address Arizona Department of Education curriculum standards in reading, writing, math and science and tailored to the learning needs of the students. Since the usual modalities of teaching (lecturing, Powerpoint presentations, independent reading) are ineffective in teaching students with special needs, we employed as much hands-on, active student participation as possible. The interactions were also easily adaptable to include every student regardless of the nature of their special needs. The effectiveness of these interactions in teaching mandated standards was evaluated using pre- and post-assessments and are presented here. Our goal is to demonstrate that special needs students benefit from being exposed to real-time science applications.

  7. All-payer ratesetting: Down but not out

    PubMed Central

    Anderson, Gerard F.

    1992-01-01

    In the United States, when the cost-containment paradigm shifted from regulation to competition, all-payer hospital ratesetting went out of favor. After reviewing the published literature and supplementing the existing literature with more current information, the author concludes that all-payer ratesetting is able to meet its multiple objectives of cost containment, reduction of the amount of cost shifting, improvement of access to the uninsured, and increased productivity. At the same time, all-payer ratesetting has not stifled the diffusion of competitive health care systems or new technology, and any impact on length of stay, admissions, and quality of care is small, if it exists at all. PMID:25371975

  8. Barriers to College Opportunity: The Unintended Consequences of State-Mandated Testing

    ERIC Educational Resources Information Center

    Perna, Laura W.; Thomas, Scott L.

    2009-01-01

    This study explores the ways that state high school testing policies shape college opportunity among students attending 15 high schools in five states. The authors use multiple descriptive case studies to explore how testing policies influence key predictors of college enrollment (e.g., high school graduation, academic preparation, knowledge, and…

  9. High school science teacher perceptions of the science proficiency testing as mandated by the State of Ohio Board of Education

    NASA Astrophysics Data System (ADS)

    Jeffery, Samuel Shird

    There is a correlation between the socioeconomic status of secondary schools and scores on the State of Ohio's mandated secondary science proficiency tests. In low scoring schools many reasons effectively explain the low test scores as a result of the low socioeconomics. For example, one reason may be that many students are working late hours after school to help with family finances; parents may simply be too busy providing family income to realize the consequences of the testing program. There are many other personal issues students face that may cause them to score poorly an the test. The perceptions of their teachers regarding the science proficiency test program may be one significant factor. These teacher perceptions are the topic of this study. Two sample groups ware established for this study. One group was science teachers from secondary schools scoring 85% or higher on the 12th grade proficiency test in the academic year 1998--1999. The other group consisted of science teachers from secondary schools scoring 35% or less in the same academic year. Each group of teachers responded to a survey instrument that listed several items used to determine teachers' perceptions of the secondary science proficiency test. A significant difference in the teacher' perceptions existed between the two groups. Some of the ranked items on the form include teachers' opinions of: (1) Teaching to the tests; (2) School administrators' priority placed on improving average test scores; (3) Teacher incentive for improving average test scores; (4) Teacher teaching style change as a result of the testing mandate; (5) Teacher knowledge of State curriculum model; (6) Student stress as a result of the high-stakes test; (7) Test cultural bias; (8) The tests in general.

  10. Results from the Mandated Evaluation of Extension's Community Resource Development Projects in the United States.

    ERIC Educational Resources Information Center

    Mulford, Charles L.; And Others

    A 1979-1980 nation-wide study of 113 Community Resource Development (CRD) projects evaluated socio-economic impacts, as seen by CRD staff, state leaders, and knowledgeable citizens. Questionnaires were sent to the three groups to determine consequences of the programs in the categories of family income, community facilities and services, public…

  11. US State Variation in Autism Insurance Mandates: Balancing Access and Fairness

    ERIC Educational Resources Information Center

    Johnson, Rebecca A.; Danis, Marion; Hafner-Eaton, Chris

    2014-01-01

    This article examines how nations split decision-making about health services between federal and sub-federal levels, creating variation between states or provinces. When is this variation ethically acceptable? We identify three sources of ethical acceptability--procedural fairness, value pluralism, and substantive fairness--and examine these…

  12. Retention of High School Economics Knowledge and the Effect of the California State Mandate

    ERIC Educational Resources Information Center

    Gill, Andrew M.; Gratton-Lavoie, Chiara

    2011-01-01

    The authors extend the literature on the efficacy of high school economics instruction in two directions. First, they assess how much economic knowledge that California students acquired in their compulsory high school course is retained on their entering college. Second, using as a control group some college students from the state of Washington,…

  13. The State's Role in Implementing Legislative Mandates: The Urban School Superintendents' Perspective.

    ERIC Educational Resources Information Center

    Tuneberg, Jeffrey

    This paper presents findings of a study that examined urban school district superintendents' perceptions of the methods by which the Ohio Department of Education (DOE) influenced Ohio's public school districts. In particular, the superintendents were asked about the influence and control utilized by the State Department of Education to implement…

  14. What Can US Single-Payer Supporters Learn From the Swiss Rejection of Single Payer?

    PubMed

    Chaufan, Claudia

    2016-01-01

    On September 27, 2014, Swiss voters rejected a proposal to replace their system of about 60 health insurance companies offering mandatory basic health coverage with a single public insurer, the state, which would offer taxpayer-funded coverage of all medically necessary care. The Swiss and the U.S. media, academia, and business sectors, from conservative and liberal camps, interpreted the results to mean a rejection of single payer and a preference for a privately run system, with important implications for health reform in the United States. While on the surface mainstream interpretations appear reasonable, I argue that they have little basis on fact because they rely on assumptions that, while untrue, are repeated as mantras that conveniently justify the continuation of a model of health insurance that is unraveling, less conspicuously in Switzerland, dramatically in the United States. To make my case, I describe the dominant narrative about Swiss health care and mainstream interpretations of the latest referendum on health reform, unpack the problem within these interpretations, and conclude by identifying what lessons the Swiss referendum contains for single payer advocates in the United States in particular and for those who struggle for social and economic rights more generally. PMID:26880092

  15. Effectiveness of a state law mandating use of bicycle helmets among children: an observational evaluation.

    PubMed

    Kanny, D; Schieber, R A; Pryor, V; Kresnow, M J

    2001-12-01

    In spring 1999, the authors evaluated the effectiveness of a 1997 Florida law requiring helmet use by all bicyclists younger than age 16 years. Sixty-four counties in Florida had enacted the bicycle helmet-use law, while the other three counties had opted out. Using a cross-sectional study design, the authors conducted unobtrusive observations at bicycle racks at public elementary schools statewide. Florida children riding bicycles in counties where the state helmet-use law was in place were twice as likely to wear helmets as children in counties without the law. In counties where the state law was in place, 16,907 (79%) of 21,313 riders observed wore a helmet, compared with only 148 (33%) of 450 riders in counties where no such law was in place (crude prevalence ratio = 2.4, 95% confidence interval: 2.1, 2.8). Helmet use by children of all racial groups exceeded 60% under the law. No significant difference in use by gender was found. These data support the positive influence of a law on bicycle helmet use among children. The data reinforce the Healthy People 2010 objective that all 50 states adopt such a law for children in order to increase helmet use and consequently reduce brain injury. PMID:11724725

  16. 42 CFR 411.22 - Reimbursement obligations of primary payers and entities that received payment from primary payers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... entities that received payment from primary payers. 411.22 Section 411.22 Public Health CENTERS FOR... Provisions § 411.22 Reimbursement obligations of primary payers and entities that received payment from primary payers. (a) A primary payer, and an entity that receives payment from a primary payer,...

  17. Effects of a State Mandated Policy (Site-Based Councils) and of Potential Role Incumbents on Teacher Screening Decisions in High and Low Performing Schools

    ERIC Educational Resources Information Center

    Young, I. Phillip; Miller-Smith, Kimberly

    2006-01-01

    Some states have viewed teacher selection as a means of improving student performance and have mandated the use of site-based teacher councils. To assess the utility of this legislative action, an experimental study was conducted. This study uses a 2x3x2 factorial design that varies state legislation, role of the decision maker, and academic…

  18. Controversies in vaccine mandates.

    PubMed

    Lantos, John D; Jackson, Mary Anne; Opel, Douglas J; Marcuse, Edgar K; Myers, Angela L; Connelly, Beverly L

    2010-03-01

    Policies that mandate immunization have always been controversial. The controversies take different forms in different contexts. For routine childhood immunizations, many parents have fears about both short- and long-term side effects. Parental worries change as the rate of vaccination in the community changes. When most children are vaccinated, parents worry more about side effects than they do about disease. Because of these worries, immunization rates go down. As immunization rates go down, disease rates go up, and parents worry less about side effects of vaccination and more about the complications of the diseases. Immunization rates then go up. For teenagers, controversies arise about the criteria that should guide policies that mandate, rather than merely recommend and encourage, certain immunizations. In particular, policy makers have questioned whether immunizations for human papillomavirus, or other diseases that are not contagious, should be required. For healthcare workers, debates have focused on the strength of institutional mandates. For years, experts have recommended that all healthcare workers be immunized against influenza. Immunizations for other infections including pertussis, measles, mumps, and hepatitis are encouraged but few hospitals have mandated such immunizations-instead, they rely on incentives and education. Pandemics present a different set of problems as people demand vaccines that are in short supply. These issues erupt into controversy on a regular basis. Physicians and policy makers must respond both in their individual practices and as advisory experts to national and state agencies. The articles in this volume will discuss the evolution of national immunization programs in these various settings. We will critically examine the role of vaccine mandates. We will discuss ways that practitioners and public health officials should deal with vaccine refusal. We will contrast responses of the population as a whole, within the

  19. Exploring barriers to payer utilization of genetic counselors.

    PubMed

    Doyle, Nan; Cirino, Allison; Trivedi, Amber; Flynn, Maureen

    2015-02-01

    Access to genetic counselors' services is neither universal nor automatic, due in part to the gatekeeper role of healthcare payers--the companies and agencies that purchase healthcare services on patients' behalf and control the bulk of healthcare spending. This pilot study surveyed and analyzed the relative importance of barriers to expanded payer coverage of genetic counselors' services. Surveys were mailed to 263 medical directors and quality assurance directors at health insurance carriers throughout the United States. Respondents provided demographic information and indicated the importance of nine possible barriers, plus an optional write-in "other." Twenty-two surveys were analyzed. "Evidence that use of genetic counselors improves health outcomes" led the list of factors having a significant/very significant influence on coverage policy. Sixteen respondents (73 %) rated this factor "4" or "5" on a Likert scale; it also received the most #1 rankings and the highest score using a weighted-mean analysis. Provider practice guidelines, CMS/Medicare regulations, and genetic counselor licensure-all of which are outside of payers' direct control-also ranked highly. The research demonstrates that although the potential barriers to expanded reimbursement for genetic counselors are numerous and complex, some are more consistently identified as important and therefore more deserving of legislative and advocacy resources to effect change. Future research should endeavor to increase survey response and include providers as well as payers. PMID:25138080

  20. Prescription Opioid Abuse: Challenges and Opportunities for Payers

    PubMed Central

    Katz, Nathaniel P.; Birnbaum, Howard; Brennan, Michael J.; Freedman, John D.; Gilmore, Gary P.; Jay, Dennis; Kenna, George A.; Madras, Bertha K.; McElhaney, Lisa; Weiss, Roger D.; White, Alan G.

    2013-01-01

    Objective Prescription opioid abuse and addiction are serious problems with growing societal and medical costs, resulting in billions of dollars of excess costs to private and governmental health insurers annually. Though difficult to accurately assess, prescription opioid abuse also leads to increased insurance costs in the form of property and liability claims, and costs to state and local governments for judicial, emergency, and social services. This manuscript’s objective is to provide payers with strategies to control these costs, while supporting safe use of prescription opioid medications for patients with chronic pain. Method A Tufts Health Care Institute Program on Opioid Risk Management meeting was convened in June 2010 with private and public payer representatives, public health and law enforcement officials, pain specialists, and other stakeholders to present research, and develop recommendations on solutions that payers might implement to combat this problem. Results While protecting access to prescription opioids for patients with pain, private and public payers can implement strategies to mitigate financial risks associated with opioid abuse, using internal strategies, such as formulary controls, claims data surveillance, and claims matching; and external policies and procedures that support and educate physicians on reducing opioid risks among patients with chronic pain. Conclusion Reimbursement policies, incentives, and health technology systems that encourage physicians to use universal precautions, to consult prescription monitoring program (PMP) data, and to implement Screening, Brief Intervention, and Referral to6Treatment protocols, have a high potential to reduce insurer risks while addressing a serious public health problem. PMID:23725361

  1. A Study of the Impact of Transformative Professional Development on Hispanic Student Performance on State Mandated Assessments of Science in Elementary School

    ERIC Educational Resources Information Center

    Johnson, Carla C.; Fargo, Jamison D.

    2014-01-01

    This paper reports the findings of a study of the impact of the transformative professional development (TPD) model on student achievement on state-mandated assessments of science in elementary school. Two schools (one intervention and one control) participated in the case study where teachers from one school received the TPD intervention across a…

  2. Linguistic Discrimination in Writing Assessment: How Raters React to African American "Errors," ESL Errors, and Standard English Errors on a State-Mandated Writing Exam

    ERIC Educational Resources Information Center

    Johnson, David; VanBrackle, Lewis

    2012-01-01

    Raters of Georgia's (USA) state-mandated college-level writing exam, which is intended to ensure a minimal university-level writing competency, are trained to grade holistically when assessing these exams. A guiding principle in holistic grading is to not focus exclusively on any one aspect of writing but rather to give equal weight to style,…

  3. Comparison of Height, Weight, and Body Mass Index Data from State-Mandated School Physical Fitness Testing and a Districtwide Surveillance Project

    ERIC Educational Resources Information Center

    Khaokham, Christina B.; Hillidge, Sharon; Serpas, Shaila; McDonald, Eric; Nader, Philip R.

    2015-01-01

    Background: Approximately one third of California school-age children are overweight or obese. Legislative approaches to assessing obesity have focused on school-based data collection. During 2010-2011, the Chula Vista Elementary School District conducted districtwide surveillance and state-mandated physical fitness testing (PFT) among fifth grade…

  4. Lost in Translation: Using Video Annotation Software to Examine How a Clinical Supervisor Interprets and Applies a State-Mandated Teacher Assessment Instrument

    ERIC Educational Resources Information Center

    Miller, Matthew James; Carney, Joanne

    2009-01-01

    This case study examines the reasoning of a clinical supervisor as she assesses preservice teacher candidates with a state-mandated performance assessment instrument. The supervisor's evaluations were recorded using video annotation software, which allowed her to record her observations in real-time. The study reveals some of the inherent…

  5. The Psoriatic Disease Payer Advisory Panel.

    PubMed

    Greb, Jacqueline E; Merola, Joseph; Garg, Amit; Latella, John; Howard, Leah; Acharya, Nayan; Gottlieb, Alice B

    2016-05-01

    A collaborative exchange of ideas occurred at The Psoriatic Disease Payer Advisory Panel sponsored by International Dermatology Outcomes Measures (IDEOM) and The National Psoriasis Foundation (NPF) in January, 2016. Patient, provider, payer, pharmaceutical industry, IDEOM board member, and NPF leader representatives shared perspectives to address the unmet needs in the treatment of psoriatic patients. The payers who play a crucial role in controlling treatment access and improving patient outcomes played a pivotal role in the discussion. Progress made during the Payer Advisory Panel will ultimately advance psoriatic initiatives and help to address the persistent challenges of all vested stakeholders.

    J Drugs Dermatol. 2016;15(5):641-644. PMID:27168273

  6. Project A.D.A.P.T.: Approaches for Developing Active Participation in State Mandated Training Programs for Child Caregivers.

    ERIC Educational Resources Information Center

    Davis-Dike, Janice

    To increase the participation of child caregivers in mandated inservice training provided at a metropolitan adult/vocational center, changes were made in the curriculum and classroom environment and the research literature was reviewed for ways of activating adult learners. Several specific program innovations were implemented, including the…

  7. A descriptive study of the reported effects of state-mandated testing on the instructional practices and beliefs of middle school science teachers

    NASA Astrophysics Data System (ADS)

    Font-Rivera, Miriam Josefa

    The purpose of this study was to investigate the effects of state-level testing on the instructional practices and beliefs of middle school science teachers. The study addressed four questions: (a) What are the beliefs of middle school science teachers regarding the pressure to improve their students' test scores? (b) What are the beliefs of middle school science teachers about how standardized tests influence their class time? (c) What are the attitudes of middle school science teachers toward state testing? and (d) What commonalities emerge from teachers' responses about the state tests? The sample was composed of 86 middle school science teachers from states that have state mandated testing programs in the area of science. Descriptive statistics and an inductive analysis were performed to answer the research questions. Teachers reported that they and their students were under a great amount of pressure to increase test scores from central office administrators and from the school principal. Teachers reported spending considerable time on certain test preparation activities throughout the school year. Teachers reported that the three strongest influences in instructional planning were reviewing the content and skills covered on the state tests prior to the test administration, having to prepare students for state tests, and adjusting the curriculum sequence based on the content tested by the state tests. Multiple-choice items were reported to be the most often used assessment strategy. Teachers reported that state-mandated tests were not very helpful because the test results presented an inaccurate picture of student learning. The categories formed from the teachers' written comments reflected the findings of the survey questions. Comments concentrated on the negative effects of the tests in the areas of pressure, overemphasis on the test, accountability, reduction of instructional time due to test preparation, and negative uses of state-mandated tests

  8. Payers' dilemma: looming costs for chronic conditions.

    PubMed

    Herskovitz, Stephen

    2005-02-01

    Biotech products for chronic conditions will be coming with regularity in the next few years, and these represent both a clinical opportunity and a financial challenge for health plans. So far, few payers have figured out how to make such treatments available without breaking the bank. The challenges ahead and strategies for handling them. PMID:23393448

  9. Payer Negotiations in the New Healthcare Environment: How to Prepare for and Succeed in a Value-Based World.

    PubMed

    Howrigon, Ron

    2016-01-01

    Because of their involvement with the Affordable Care exchanges, the national insurance companies have reported significant financial losses. As a result, there will soon be significant payer pressure to reduce medical expenses. To succeed in future negotiations with the payers, medical practices must understand the needs of the payers and then play to those needs. The author is a former managed care executive with more than 25 years of experience managing provider networks and implementing payer strategies for some of the largest payers in the United States. In this article, he outlines important things medical practices should be doing to prepare for the new world of value-based contracting. Medical practices that embrace this change and work hard to evolve with the future are the ones that are going to survive and succeed. PMID:27443057

  10. A Mandate for Native History

    ERIC Educational Resources Information Center

    Pember, Mary Annette

    2007-01-01

    The Montana Indian Education For All Act may be setting an audacious national precedent for America's primary and secondary schools. The law requires all Montana schools to include curricula about the history, culture and contemporary status of the state's American Indian population. The new constitutional mandate has eyes throughout Native…

  11. The impact of high-stakes, state-mandated student performance assessment on 10th grade English, mathematics, and science teachers' instructional practices

    NASA Astrophysics Data System (ADS)

    Vogler, Kenneth E.

    The purpose of this study was to determine if the public release of student results on high-stakes, state-mandated performance assessments influence instructional practices, and if so in what manner. The research focused on changes in teachers' instructional practices and factors that may have influenced such changes since the public release of high-stakes, state-mandated student performance assessment scores. The data for this study were obtained from a 54-question survey instrument given to a stratified random sample of teachers teaching at least one section of 10th grade English, mathematics, or science in an academic public high school within Massachusetts. Two hundred and fifty-seven (257) teachers, or 62% of the total sample, completed the survey instrument. An analysis of the data found that teachers are making changes in their instructional practices. The data show notable increases in the use of open-response questions, creative/critical thinking questions, problem-solving activities, use of rubrics or scoring guides, writing assignments, and inquiry/investigation. Teachers also have decreased the use of multiple-choice and true-false questions, textbook-based assignments, and lecturing. Also, the data show that teachers felt that changes made in their instructional practices were most influenced by an "interest in helping my students attain MCAS assessment scores that will allow them to graduate high school" and by an "interest in helping my school improve student (MCAS) assessment scores," Finally, mathematics teachers and teachers with 13--19 years of experience report making significantly more changes than did others. It may be interpreted from the data that the use of state-mandated student performance assessments and the high-stakes attached to this type of testing program contributed to changes in teachers' instructional practices. The changes in teachers' instructional practices have included increases in the use of instructional practices deemed

  12. The Efficiency of a Group-Specific Mandated Benefit Revisited: The Effect of Infertility Mandates

    ERIC Educational Resources Information Center

    Lahey, Joanna N.

    2012-01-01

    This paper examines the labor market effects of state health insurance mandates that increase the cost of employing a demographically identifiable group. State mandates requiring that health insurance plans cover infertility treatment raise the relative cost of insuring older women of child-bearing age. Empirically, wages in this group are…

  13. Partnering with payers? Key lessons to keep in mind.

    PubMed

    Eggbeer, Bill; Sears, Kevin; Homer, Kenneth

    2014-01-01

    Key factors healthcare leaders might wish to consider when evaluating potential partnerships with payers include: Use of safeguards to prevent a payer from using benefit design to shift expected volume from high-revenue service lines or channels. Right to participate in narrow networks. Use of segment-specific language, which protects providers from payers that may try to extend a rate decrease from one patient segment to another. Exclusive co-branding. Automatic price increases if volume is not achieved. PMID:24511782

  14. The role of value in provider-patient-payer relationships.

    PubMed

    Benson, Keith J; Weech-Maldonado, Robert; Gamm, Larry D

    2003-01-01

    Value is becoming a topic of interest to 3 key players in the healthcare field-patients, payers, and providers. This article examines various value definitions and puts forth a composite value definition incorporating cost, quality, and worth elements. A value triad is created to demonstrate how value can be a linking mechanism between patient, payers and providers. Examples are then provided to assist managers in examining the value associated with payers and patients. PMID:15141848

  15. Leading the Way: State Mandates for School Advisory Councils in California, Florida and South Carolina. A Report.

    ERIC Educational Resources Information Center

    Zerchykov, Ross; And Others

    This report reviews the pioneering efforts in California, Florida, and South Carolina to foster citizen participation through school councils and provides data and analysis on one promising policy innovation in each of the states. The experience in the three states suggests that institutional mechanisms are in place, precedents have been set, and…

  16. Large Mandates and Limited Resources: State Response to the "No Child Left Behind Act" and Implications for Accountability

    ERIC Educational Resources Information Center

    Kim, Jimmy; Sunderman, Gail L.

    2004-01-01

    This report examines how state policymakers designed their accountability systems to meet the NCLB Title I requirements and the implications of its provisions for schools with large numbers of low-income and minority students. The authors conducted their study in six states--Arizona, California, Illinois, New York, Virginia, and Georgia--which are…

  17. Maryland's Global Hospital Budgets--Preliminary Results from an All-Payer Model.

    PubMed

    Patel, Ankit; Rajkumar, Rahul; Colmers, John M; Kinzer, Donna; Conway, Patrick H; Sharfstein, Joshua M

    2015-11-12

    In the first year of Maryland's experiment in setting all-payer rates for hospital services, costs were contained and the quality of care improved, though the state still has high rates of hospital admissions and per capita spending for Medicare patients. PMID:26559570

  18. Managing Mandated Educational Change

    ERIC Educational Resources Information Center

    Clement, Jennifer

    2014-01-01

    This paper explores teachers' perspectives on the management of mandated educational change in order to understand how it may be managed more effectively. A case study of teachers' responses to the introduction of a quality teaching initiative in two New South Wales schools found that while some teachers described the strong negative…

  19. Plessy v. Ferguson Mandate.

    ERIC Educational Resources Information Center

    Mueller, Jean West; Schamel, Wynell Burroughs

    1989-01-01

    Traces the history of the Plessy v. Ferguson case. Includes copies of the U.S. Supreme Court mandate to the Louisiana Supreme Court denying Plessy's request to overturn the Jim Crow law and ordering him to bear the court costs. Provides teaching suggestions for interpreting the document and highlights related topics and questions for research and…

  20. Student Transportation Mandate. A Report and Preliminary Recommendations.

    ERIC Educational Resources Information Center

    Illinois State Board of Education, Springfield.

    As part of a comprehensive study of all mandates placed by the state of Illinois on elementary and secondary education, an analysis was undertaken of the student transportation mandate in its historical perspective, inquiring into its original purpose, how well that purpose has been served, whether the mandate is still needed, and whether a…

  1. Perceived Effects of State-Mandated Testing Programs on Teaching and Learning: Findings from a National Survey of Teachers.

    ERIC Educational Resources Information Center

    Pedulla, Joseph J.; Abrams, Lisa M.; Madaus, George F.; Russell, Michael K.; Ramos, Miguel A.; Miao, Jing

    Results from a national survey of teachers are reported for five types of state testing programs, those with: (1) high stakes for districts, schools, or teachers, and students; (2) high stakes for districts, schools, and teachers, and moderate stakes for students; (3) high stakes for districts, schools, and teachers, and low stakes for students;…

  2. Mandating better buildings: a global review of building codes and prospects for improvement in the United States

    DOE PAGESBeta

    Sun, Xiaojing; Brown, Marilyn A.; Cox, Matt; Jackson, Roderick

    2015-03-11

    This paper provides a global overview of the design, implementation, and evolution of building energy codes. Reflecting alternative policy goals, building energy codes differ significantly across the United States, the European Union, and China. This review uncovers numerous innovative practices including greenhouse gas emissions caps per square meter of building space, energy performance certificates with retrofit recommendations, and inclusion of renewable energy to achieve “nearly zero-energy buildings”. These innovations motivated an assessment of an aggressive commercial building code applied to all US states, requiring both new construction and buildings with major modifications to comply with the latest version of themore » ASHRAE 90.1 Standards. Using the National Energy Modeling System (NEMS), we estimate that by 2035, such building codes in the United States could reduce energy for space heating, cooling, water heating and lighting in commercial buildings by 16%, 15%, 20% and 5%, respectively. Impacts on different fuels and building types, energy rates and bills as well as pollution emission reductions are also examined.« less

  3. Mandating better buildings: a global review of building codes and prospects for improvement in the United States

    SciTech Connect

    Sun, Xiaojing; Brown, Marilyn A.; Cox, Matt; Jackson, Roderick

    2015-03-11

    This paper provides a global overview of the design, implementation, and evolution of building energy codes. Reflecting alternative policy goals, building energy codes differ significantly across the United States, the European Union, and China. This review uncovers numerous innovative practices including greenhouse gas emissions caps per square meter of building space, energy performance certificates with retrofit recommendations, and inclusion of renewable energy to achieve “nearly zero-energy buildings”. These innovations motivated an assessment of an aggressive commercial building code applied to all US states, requiring both new construction and buildings with major modifications to comply with the latest version of the ASHRAE 90.1 Standards. Using the National Energy Modeling System (NEMS), we estimate that by 2035, such building codes in the United States could reduce energy for space heating, cooling, water heating and lighting in commercial buildings by 16%, 15%, 20% and 5%, respectively. Impacts on different fuels and building types, energy rates and bills as well as pollution emission reductions are also examined.

  4. Culture clash: aligning payers and providers for real reform.

    PubMed

    Bauer, Jeffrey C

    2010-04-01

    Self-imposed cost containment is not part of providers' heritage. The payer business model and its problems are complicated; simplistic reforms won't help. Health reform needs to be refocused on policies that allow providers and payers to align their cultures so that all parties benefit from potential synergies to provide top-quality care as inexpensively as possible. PMID:20358879

  5. Use of Diagnosis-Related Groups by Non-Medicare Payers

    PubMed Central

    Carter, Grace M.; Jacobson, Peter D.; Kominski, Gerald F.; Perry, Mark J.

    1994-01-01

    Medicare's prospective payment system (PPS) for hospital cases is based on diagnosis-related groups (DRGs). A wide variety of other third-party payers for hospital care have adapted elements of this system for their own use. The extent of DRG use varies considerably both by type of payer and by geographical area. Users include: 21 State Medicaid programs, 3 workers' compensation systems, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), more than one-half of the Blue Cross and Blue Shield Association (BCBSA) member plans, several self-insured employers, and a few employer coalitions. We describe how each of these payers use DRGs. No single approach is dominant. Some payers negotiate specific prices for so many combinations of DRG and hospital that the paradigm that payment equals rate times weight does not apply. What has emerged appears to be a very flexible payment system in which the only constant is the use of DRGs as a measure of output. PMID:10142368

  6. A Study of the Impact of Transformative Professional Development on Hispanic Student Performance on State Mandated Assessments of Science in Elementary School

    NASA Astrophysics Data System (ADS)

    Johnson, Carla C.; Fargo, Jamison D.

    2014-11-01

    This paper reports the findings of a study of the impact of the transformative professional development (TPD) model on student achievement on state-mandated assessments of science in elementary school. Two schools (one intervention and one control) participated in the case study where teachers from one school received the TPD intervention across a 2-year period while teachers at the other school received no program and continued business as usual. The TPD program includes a focus on the core conceptual framework for effective professional development (Desimone in Educ Res 38:181-199, 2009) as well as an emphasis on culturally relevant pedagogy (CRP) and other effective science instructional strategies. Findings revealed that participation in TPD had a significant impact on student achievement for Burns Elementary with the percentage of proficient students growing from 25 % at baseline to 67 % at the end of the 2-year program, while the comparison school did not experience similar growth. Implications for future research and implementation of professional development programs to meet the needs of teachers in the realm of CRP in science are discussed.

  7. Bilingual Mandate Challenges Chicago's Public Preschools

    ERIC Educational Resources Information Center

    Zehr, Mary Ann

    2010-01-01

    Administrators in the Chicago public schools are seeking to strike the right balance between providing guidance and permitting flexibility as they put in place the nation's first state mandate for providing bilingual education to preschoolers. New rules approved by the Illinois state board of education in June flesh out a January 2009 change that…

  8. Fla. Budget Threatens Online Ed. Mandate

    ERIC Educational Resources Information Center

    Manzo, Kathleen Kennedy

    2009-01-01

    As Florida school districts scramble to meet a looming state mandate to offer full-time online instruction for K-8 students, and as high school enrollments in such courses continue to climb, lawmakers are mulling restrictions and budget cuts for the state's nationally known virtual school. Together, online-learning advocates say, the growing…

  9. Responding to Accountability Mandates. ERIC Digest.

    ERIC Educational Resources Information Center

    Outcalt, Charles; Rabin, Joel

    In recent years, community colleges have developed innovative assessment programs to respond to more explicit state guidelines and mandates for greater accountability. In California, for example, the State Assembly began requiring community colleges to address specific educational and fiscal performance issues in assessments in 1989, while…

  10. The efficiency of a group-specific mandated benefit revisited: the effect of infertility mandates.

    PubMed

    Lahey, Joanna N

    2012-01-01

    This paper examines the labor market effects of state health insurance mandates that increase the cost of employing a demographically identifiable group. State mandates requiring that health insurance plans cover infertility treatment raise the relative cost of insuring older women of child-bearing age. Empirically, wages in this group are unaffected, but their total labor input decreases. Workers do not value infertility mandates at cost, and so will not take wage cuts in exchange, leading employers to decrease their demand for this affected and identifiable group. Differences in the empirical effects of mandates found in the literature are explained by a model including variations in the elasticity of demand, moral hazard, ability to identify a group, and adverse selection. PMID:22180892

  11. Perceived Effects of State-Mandated Testing Programs on Teaching and Learning: Findings from Interviews with Educators in Low-, Medium-, and High-Stakes States.

    ERIC Educational Resources Information Center

    Clarke, Marguerite; Shore, Arnold; Rhoades, Kathleen; Abrams, Lisa; Miao, Jing; Li, Jie

    The goal of this study was to identify the effects of state-level standards-based reform on teaching and learning, paying particular attention to the state test and associated stakes. On-site interviews were conducted with 360 educators (elementary, middle, and high school teachers) in 3 states (120 in each state) attaching different stakes to the…

  12. Time to Insurance Approval in Private and Public Payers Does Not Influence Survival in Patients Who Undergo Hematopoietic Cell Transplantation.

    PubMed

    Bhatt, Vijaya Raj; Loberiza, Fausto R; Schmit-Pokorny, Kim; Lee, Stephanie J

    2016-06-01

    In the United States, insurance status has been implicated as a barrier to obtaining timely treatment. In this retrospective cohort study of 521 patients who underwent first hematopoietic cell transplantation (HCT), we investigated the association between timeliness of HCT and overall survival. Timeliness was operationally defined in the following 3 ways: (1) payer approval, from request for approval to actual payer approval; (2) transplantation speed, from payer approval to time of actual HCT; and (3) total time, from request for approval to HCT. Patients with private insurance had longer time to payer approval (P < .0001) than those with public payers but shorter time from approval to actual HCT (P < .0001) and total time to HCT (P < .0001). Multivariate Cox regression showed no significant differences in risk of death between slow and fast times in the 3 indices of timeliness in the models that used all patients (n = 509), autologous HCT in lymphoma (n = 278), and autologous HCT in multiple myeloma (n = 121). Additional studies to evaluate the effect of insurance timeliness on all patients for whom HCT is recommended, not just those who undergo HCT, should be conducted. PMID:26988742

  13. Mandated Preparation Program Redesign: Kentucky Case

    ERIC Educational Resources Information Center

    Browne-Ferrigno, Tricia

    2013-01-01

    This case study presents a chronicle of events spanning a decade in Kentucky that led to state policy changes for principal preparation and details the response to those mandated changes by professors at the University of Kentucky. Professors' collaborative efforts resulted in a new teacher leadership program and redesigned principal…

  14. Child Abuse and Mandated Reporting

    ERIC Educational Resources Information Center

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

    Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…

  15. Biosimilars: Opportunities to Promote Optimization Through Payer and Provider Collaboration.

    PubMed

    Manolis, Chronis H; Rajasenan, Kiran; Harwin, William; McClelland, Scott; Lopes, Maria; Farnum, Carolyn

    2016-09-01

    A panel was convened that consisted of 1 medical director, 2 pharmacy directors, and 2 oncologists, who represented the University of Pittsburgh Medical Center Health Plan, an integrated delivery network, and Florida Blue, a progressive regional health plan. This panel met in order to share ideas, discuss challenges, and develop practical solutions to promote optimal utilization in order to encourage collaboration between payers and providers to help ensure the success of biosimilar entrants into the marketplace. Live meetings were conducted in Orlando, Florida, and Pittsburgh, Pennsylvania, and were followed by virtual meetings to solidify ideas and concepts for this supplement. It is important for biosimilar manufacturers to identify potential payer, provider, and patient obstacles in order to develop strategic and tactical plans to preemptively address these potential obstacles. Gathering payer and provider insights will shed light on various issues such as access and reimbursement. Biosimilar manufacturers must be proactive in the education of payers, providers, and patients to ensure access to biosimilars. A strong factor emphasized among this group was that the assumption surrounding biosimilar development and use is the potential for health care cost savings. According to the panel, payers and providers must carefully consider economic implications and potential cost-effectiveness in order to increase the acceptance or understanding of biosimilars in clinical practice. The group identified 3 major challenges surrounding biosimilar adoption: (1) provider confidence in biosimilar education and clinical value, (2) provider confidence in reimbursement for new biosimilars, and (3) creating shared payer and provider cost-savings. After identification of the 3 challenges, the group posed potential solutions to help with biosimilar adoption. PMID:27579939

  16. A Comparative Analysis of Mandated Benefit Laws, 1949–2002

    PubMed Central

    Laugesen, Miriam J; Paul, Rebecca R; Luft, Harold S; Aubry, Wade; Ganiats, Theodore G

    2006-01-01

    Objective To understand and compare the trends in mandated benefits laws in the United States. Data Sources/Study Setting Mandated benefit laws enacted in 50 states and the District of Columbia for the period 1949–2002 were compiled from multiple published compendia. Study Design Laws that require private insurers and health plans to cover particular services, types of diseases, or care by specific providers in 50 states and the District of Columbia are compared for the period 1949–2002. Legislation is compared by year, by average and total frequency, by state, by type (provider, health care service, or preventive), and according to whether it requires coverage or an offer of coverage. Data Collection/Extraction Method Data from published tables were entered into a spreadsheet and analyzed using statistical software. Principal Findings A total of 1,471 laws mandated coverage for 76 types of providers and services. The most common type of mandated coverage is for specific health care services (670 laws for 34 different services), followed by laws for services offered by specific professionals and other providers (507 mandated benefits laws for 25 types of providers), and coverage for specific preventive services (295 laws for 17 benefits). On average, a mandated benefit law has been adopted or significantly revised by 19 states, and each state has approximately 29 mandates. Only two benefits (minimum maternity stay and breast reconstruction) are mandated in all 51 jurisdictions and these were also federally mandated benefits. The mean number of total mandated benefit laws adopted or significantly revised per year was 17 per year in the 1970s, 36 per year in the 1980s, 59 per year in the 1990s, and 76 per year between 2000 and 2002. Since 1990, mandate adoption increased substantially, with around 55 percent of all mandated benefit laws enacted between 1990 and 2002. Conclusions There was a large increase in the number of mandated benefits laws during the managed

  17. 42 CFR 422.108 - Medicare secondary payer (MSP) procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Medicare secondary payer (MSP) procedures. 422.108 Section 422.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections §...

  18. 42 CFR 422.108 - Medicare secondary payer (MSP) procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Medicare secondary payer (MSP) procedures. 422.108 Section 422.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections §...

  19. 42 CFR 423.462 - Medicare secondary payer procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Medicare secondary payer procedures. 423.462 Section 423.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part...

  20. 42 CFR 422.108 - Medicare secondary payer (MSP) procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Medicare secondary payer (MSP) procedures. 422.108 Section 422.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Benefits and...

  1. 42 CFR 423.462 - Medicare secondary payer procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Medicare secondary payer procedures. 423.462 Section 423.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT...

  2. 42 CFR 423.462 - Medicare secondary payer procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Medicare secondary payer procedures. 423.462 Section 423.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part...

  3. 42 CFR 422.108 - Medicare secondary payer (MSP) procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Medicare secondary payer (MSP) procedures. 422.108 Section 422.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Benefits and...

  4. 42 CFR 422.108 - Medicare secondary payer (MSP) procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Medicare secondary payer (MSP) procedures. 422.108 Section 422.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Benefits and...

  5. 42 CFR 423.462 - Medicare secondary payer procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Medicare secondary payer procedures. 423.462 Section 423.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT...

  6. 42 CFR 423.462 - Medicare secondary payer procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Medicare secondary payer procedures. 423.462 Section 423.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT...

  7. Payers' Perspectives: Health Economics Outcomes in Managed Care

    PubMed Central

    Bankhead, Charles

    2015-01-01

    The following summaries represent a sample of the many studies presented at the 27th Annual Meeting of the Academy of Managed Care Pharmacy (AMCP), April 7–10, 2015, in San Diego, CA. These summaries highlight some of the main trends in the current US healthcare, reflecting the impact of real-world, evidence-based issues of high interest for payers, employers, drug manufacturers, providers, patients, and other healthcare stakeholders. PMID:26085902

  8. US physician practices versus Canadians: spending nearly four times as much money interacting with payers.

    PubMed

    Morra, Dante; Nicholson, Sean; Levinson, Wendy; Gans, David N; Hammons, Terry; Casalino, Lawrence P

    2011-08-01

    Physician practices, especially the small practices with just one or two physicians that are common in the United States, incur substantial costs in time and labor interacting with multiple insurance plans about claims, coverage, and billing for patient care and prescription drugs. We surveyed physicians and administrators in the province of Ontario, Canada, about time spent interacting with payers and compared the results with a national companion survey in the United States. We estimated physician practices in Ontario spent $22,205 per physician per year interacting with Canada's single-payer agency--just 27 percent of the $82,975 per physician per year spent in the United States. US nursing staff, including medical assistants, spent 20.6 hours per physician per week interacting with health plans--nearly ten times that of their Ontario counterparts. If US physicians had administrative costs similar to those of Ontario physicians, the total savings would be approximately $27.6 billion per year. The results support the opinion shared by many US health care leaders interviewed for this study that interactions between physician practices and health plans could be performed much more efficiently. PMID:21813866

  9. Cost-Effectiveness of Global Endometrial Ablation vs. Hysterectomy for Treatment of Abnormal Uterine Bleeding: US Commercial and Medicaid Payer Perspectives

    PubMed Central

    Lenhart, Gregory M.; Bonafede, Machaon M.; Lukes, Andrea S.; Laughlin-Tommaso, Shannon K.

    2015-01-01

    Abstract Cost-effectiveness modeling studies of global endometrial ablation (GEA) for treatment of abnormal uterine bleeding (AUB) from a US perspective are lacking. The objective of this study was to model the cost-effectiveness of GEA vs. hysterectomy for treatment of AUB in the United States from both commercial and Medicaid payer perspectives. The study team developed a 1-, 3-, and 5-year semi-Markov decision-analytic model to simulate 2 hypothetical patient cohorts of women with AUB—1 treated with GEA and the other with hysterectomy. Clinical and economic data (including treatment patterns, health care resource utilization, direct costs, and productivity costs) came from analyses of commercial and Medicaid claims databases. Analysis results show that cost savings with simultaneous reduction in treatment complications and fewer days lost from work are achieved with GEA versus hysterectomy over almost all time horizons and under both the commercial payer and Medicaid perspectives. Cost-effectiveness metrics also favor GEA over hysterectomy from both the commercial payer and Medicaid payer perspectives—evidence strongly supporting the clinical-economic value about GEA versus hysterectomy. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments. (Population Health Management 2015;18:373–382) PMID:25714906

  10. Mandated Psychotherapy with the Impaired Physician

    PubMed Central

    2008-01-01

    Physicians and other prescribers of medication are in a unique position with regard to substance misuse. Each physician must abide by the licensing guidelines of the state medical board in their geographical location of practice. When a physician has legal charges regarding substance use, he or she must report to the medical board and undergo monitoring for several years. The recommendations of the board may include mandatory psychotherapy. The following composite cases are illustrative of the implications of one physician treating another physician under the auspices of a mandate. PMID:19727294

  11. Physician response to fee changes with multiple payers.

    PubMed

    McGuire, T G; Pauly, M V

    1991-01-01

    This paper develops a general model of physician behavior with demand inducement encompassing the two benchmark cases of profit maximization and target-income behavior. It is shown that when income effects are absent, physicians maximize profits, and when income effects are very strong, physicians seek a target income. The model is used to derive own and cross-price expressions for the response of physicians to fee changes in the realistic context of more than one payer under the alternative behavior assumptions of profit maximization and target income behavior. The implications for public and private fee policy, and empirical research on physician response to fees, are discussed. PMID:10117011

  12. State-Level Mandates for Financial Literacy Education, JA Finance Park, and the Impact on Eighth-Grade Students in Colorado

    ERIC Educational Resources Information Center

    Mitchell, Sherri L.

    2013-01-01

    In 2008, the Colorado General Assembly passed legislation requiring the adoption of personal financial literacy (PFL) education standards for kindergarten through 12th-grade students. Beginning in 2014, the state plans to conduct standardized testing to determine financial literacy of 3rd- through 12th-grade students. The state did not allocate…

  13. 40 CFR 1500.3 - Mandate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Mandate. 1500.3 Section 1500.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY PURPOSE, POLICY, AND MANDATE § 1500.3 Mandate... significant impact (when such a finding will result in action affecting the environment), or takes action...

  14. 40 CFR 1500.3 - Mandate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Mandate. 1500.3 Section 1500.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY PURPOSE, POLICY, AND MANDATE § 1500.3 Mandate... significant impact (when such a finding will result in action affecting the environment), or takes action...

  15. 40 CFR 1500.3 - Mandate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Mandate. 1500.3 Section 1500.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY PURPOSE, POLICY, AND MANDATE § 1500.3 Mandate... significant impact (when such a finding will result in action affecting the environment), or takes action...

  16. How to Successfully Survive a Mandated Project

    ERIC Educational Resources Information Center

    Ellern, Jill

    2011-01-01

    With information technologies' pervasive use within all departments and by all staff, libraries and library staff get their fair share of mandated projects. Knowing how to successfully operate in this kind of environment is important to the overall success of the library as a whole. What is meant by mandated project? A mandated project is a…

  17. Biosimilars: How Can Payers Get Long-Term Savings?

    PubMed

    Mestre-Ferrandiz, Jorge; Towse, Adrian; Berdud, Mikel

    2016-06-01

    The term 'biosimilar' refers to an alternative similar version of an off-patent innovative originator biotechnology product (the 'reference product'). Several biosimilars have been approved in Europe, and a number of top-selling biological medicines have lost, or will lose, patent protection over the next 5 years. We look at the experience in Europe so far. The USA has finally implemented a regulatory route for biosimilar approval. We recommend that European and US governments and payers take a strategic approach to get value for money from the use of biosimilars by (1) supporting and incentivising generation of high-quality comprehensive outcomes data on the effectiveness and safety of biosimilars and originator products; and (2) ensuring that incentives are in place for budget holders to benefit from price competition. This may create greater willingness on the part of budget holders and clinicians to use biosimilar and originator products with comparable outcomes interchangeably, and may drive down prices. Other options, such as direct price cuts for originator products or substitution rules without outcomes data, are likely to discourage biosimilar entry. With such approaches, governments may achieve a one-off cut in originator prices but may put at risk the creation of a more competitive market that would, in time, produce much greater savings. It was the creation of competitive markets for chemical generic drugs-notably, in the USA, the UK and Germany-rather than price control, that enabled payers to achieve the high discounts now taken for granted. PMID:26792791

  18. Sex education mandates: are they the answer?

    PubMed

    Muraskin, L D

    1986-01-01

    This article examines the question of mandating family life education in schools. Findings are presented of a recent study on the implementation of New Jersey's family life education requirement, (proposed by the State Board of Education and Education Department) which, in its original form in 1979, required that 31 specific topics be addressed by the end of high school; (e.g. human reproduction, child abuse and assault, and others). Intense pressure from conservative activist groups, education associations fearing a threat to local control of curricula, and important elements of the press, caused a change in the language of the draft regulation to be much less specific. In 5 school districts selected, the norm was conformity to the very broad mandates simply by verifying that certain topics were touched on in courses already offered in the curriculum. Teachers did not seem motivated to give out more than simple correct information on human reproduction, and family life education is commonly discussed in a limited way as part of health education. Beyond more emphasis being placed on the topic of child abuse in elementary schools, little structural change took place in curricula, and there was little actual training of staff. In a 6th district (chosen on the basis of prior knowledge about its program), specific teacher training and curriculum development were evident. It is proposed that information connected with reproduction be regared as something students have a right to know, and that family life education be designed with this goal in mind, and not with the idea of making a political staement, or with the strategy of politically dangerous mandates. PMID:3792530

  19. The Working Patient with Cancer: Implications for Payers and Employers

    PubMed Central

    Lawless, Grant D.

    2009-01-01

    Cancer is seen today more often as a manageable chronic disease, resulting in changing workplace characteristics of the patient with cancer. A growing number of employees continue to work while being treated for cancer or return to work shortly after their cancer treatment is completed. To respond to these changes and the potential impact on the working patient's attitude, employers need updated, factual information related to this patient population. This type of information will support future benefit considerations by employers on employee contributions and future employee health and productivity. In 2005, Amgen launched a 3-year initiative to better understand cancer as a chronic disease, as well as the impact on the working patient with cancer and on the employer. The data from this initiative described in this article provide insights into cancer as a chronic and manageable disease in the workforce, and the broader implications to payers and employers. PMID:25126288

  20. 78 FR 57800 - Medicare Program; Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ... security feature known as multifactor authentication to the Web portal. Multifactor authentication uses a...; Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal AGENCY: Centers for... Medicare Secondary Payer (MSP) Web portal to conform to section 201 of the Medicare IVIG and...

  1. 38 CFR 17.106 - VA collection rules; third-party payers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false VA collection rules; third-party payers. 17.106 Section 17.106 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Charges, Waivers, and Collections § 17.106 VA collection rules; third-party payers. (a)(1) General rule. VA has the right to...

  2. 38 CFR 17.106 - VA collection rules; third-party payers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false VA collection rules; third-party payers. 17.106 Section 17.106 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Charges, Waivers, and Collections § 17.106 VA collection rules; third-party payers. (a)(1) General rule. VA has the right to...

  3. Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix.

    PubMed

    Pines, Jesse M; Zocchi, Mark; Moghtaderi, Ali; Black, Bernard; Farmer, Steven A; Hufstetler, Greg; Klauer, Kevin; Pilgrim, Randy

    2016-08-01

    In 2014 twenty-eight states and the District of Columbia had expanded Medicaid eligibility while federal and state-based Marketplaces in every state made subsidized private health insurance available to qualified individuals. As a result, about seventeen million previously uninsured Americans gained health insurance in 2014. Many policy makers had predicted that Medicaid expansion would lead to greatly increased use of hospital emergency departments (EDs). We examined the effect of insurance expansion on ED use in 478 hospitals in 36 states during the first year of expansion (2014). In difference-in-differences analyses, Medicaid expansion increased Medicaid-paid ED visits in those states by 27.1 percent, decreased uninsured visits by 31.4 percent, and decreased privately insured visits by 6.7 percent during the first year of expansion compared to nonexpansion states. Overall, however, total ED visits grew by less than 3 percent in 2014 compared to 2012-13, with no significant difference between expansion and nonexpansion states. Thus, the expansion of Medicaid coverage strongly affected payer mix but did not significantly affect overall ED use, even though more people gained insurance coverage in expansion states than in nonexpansion states. This suggests that expanding Medicaid did not significantly increase or decrease overall ED visit volume. PMID:27503974

  4. Guidelines and Value-Based Decision Making: An Evolving Role for Payers.

    PubMed

    McCauley, Janet L

    2015-01-01

    Payers use evidence-based guidelines to promote effective health diagnoses and treatments for their members and to ensure that members are not subject to harmful or wasteful care. Payer guidelines inform coverage, but the content of these guidelines relies on the same evidentiary base as clinical treatment guidelines. Recent strategies to foster value through benefit design and alternative reimbursement methodologies illustrate emerging applications for evidence-based guidelines. The current focus on cost effectiveness within health technology assessment, comparative effectiveness research in collaboration with payers, and transparency around payer evidence assessment could better align payers' interests in evidence-based care with those of other stakeholders. The move to value in health care will depend upon credible clinical evidence to enable informed decision making. PMID:26509518

  5. Are Teachers Prepared? Predictors of Teachers' Readiness to Serve as Mandated Reporters of Child Abuse

    ERIC Educational Resources Information Center

    Greytak, Emily A.

    2009-01-01

    The Child Abuse Prevention and Treatment Act (1974) requires that states receiving U.S. federal funds directed at child abuse implement mandated reporting laws. As a result, all states have adopted legislation requiring teachers and other professionals who deal with children to report suspicions of child abuse. The federal mandate for such…

  6. Mandated Mental Health Insurance: A Complex Case of Pros and Cons. Human Resources Series.

    ERIC Educational Resources Information Center

    Paterson, Andrea

    1986-01-01

    The pros and cons of state laws mandating mental health insurance are discussed in this report. The history of a 1985 Supreme Court case which held that states could mandate mental health benefits introduces the report. In an overview of the issue, the long-standing argument between the insurance industry and the mental health establishment is…

  7. States Address Civics with Mandated Task Forces

    ERIC Educational Resources Information Center

    Delander, Brady

    2014-01-01

    By coincidence or not, Massachusetts, Illinois and Virginia created civic education task forces not long after national test results showed a dismal understanding of the subject matter across all grade levels. Results of the 2010 National Assessment of Educational Progress showed just 25 percent of all testtakers in grades 4, 8 and 12 demonstrated…

  8. Treatment of Depression in Voluntary Versus Mandated Physicians.

    PubMed

    Johnson, R Scott; Fowler, J Christopher; Sikes, Kristi A; Allen, Jon G; Oldham, John M

    2015-12-01

    Few if any publications discuss the effectiveness of voluntary versus mandated treatment for impaired physicians. This retrospective case-control study compared the recovery rates of physicians whose treatment was mandated or coerced by either licensure boards or employers (mandated physicians) with the rates for physicians admitted voluntarily (voluntary physicians) to the Menninger Clinic's Professionals in Crisis program from 2009 through 2012. Beck Depression Inventory (BDI)-II scores served as the primary outcome measure. At the time of admission, voluntary physicians were more depressed, but the improvement rates in the voluntary and mandated groups did not differ significantly. In addition, the two groups differed neither in rates of return to the healthy range of BDI-II scores, nor in whether BDI-II scores had decreased by at least two standard deviations by the time of discharge. These findings suggest that state physician health programs can continue to mandate physicians into treatment despite concerns that mandatory treatment may be less efficacious than voluntary treatment. PMID:26668225

  9. Gene therapy, fundamental rights, and the mandates of public health.

    PubMed

    Lynch, John

    2004-01-01

    Recent and near-future developments in the field of molecular biology will make possible the treatment of genetic disease on an unprecedented scale. The potential applications of these developments implicate important public policy considerations. Among the questions that may arise is the constitutionality of a state-mandated program of gene therapy for the purpose of eradicating certain genetic diseases. Though controversial, precedents of public health jurisprudence suggest that such a program could survive constitutional scrutiny. This article provides an overview of gene therapy in the context of fundamental rights and the mandates of public health. PMID:15255004

  10. Intergovernmental Mandates in Federal Legislation. Economic and Budget Issue Brief

    ERIC Educational Resources Information Center

    Lex, Leo

    2009-01-01

    Federal law sometimes requires state, local, or tribal governments to spend money to achieve certain goals. In some cases, a requirement is imposed as a condition for receiving federal aid; in others, requirements can be imposed through the exercise of the federal government's sovereign power. The Unfunded Mandates Reform Act of 1995 (UMRA)…

  11. Using External Accountability Mandates to Create Internal Change

    ERIC Educational Resources Information Center

    Petrides, Lisa A.; McClelland, Sara I.; Nodine, Thad R.

    2004-01-01

    In light of a new state-mandated performance-based funding mechanism for community colleges in California, this article discusses how one district sought to implement new internal evaluation procedures to improve student outcomes in line with systemwide goals outlined in the performance-based funding. These efforts introduced an evaluative …

  12. External Mandates and Instructional Leadership: School Leaders as Mediating Agents

    ERIC Educational Resources Information Center

    Louis, Karen Seashore; Robinson, Viviane M.

    2012-01-01

    Purpose: The purpose of this paper is to examine how US school leaders make sense of external mandates, and the way in which their understanding of state and district accountability policies affects their work. It is posited that school leaders' responses to external accountability are likely to reflect a complex interaction between their…

  13. The Mandate: To Identify Children with Handicapping Conditions.

    ERIC Educational Resources Information Center

    Mazzullo, Mariann C.

    Reviewed are 10 Child Find projects to locate possibly handicapped children as mandated by Public Law 94-142 with particular emphasis on Child Find activities in New York State. Noted are efforts of Colorado, and Idaho including public awareness campaigns, and screening programs. It is reported that more than 30 projects have been funded in New…

  14. Mandated Reporting Thresholds for Community Professionals

    ERIC Educational Resources Information Center

    Crowell, Kathryn; Levi, Benjamin H.

    2012-01-01

    This study examines how community-based mandated reporters understand and interpret "reasonable suspicion", the standard threshold for mandated reporting of suspected child abuse. Respondents were asked to identify the probability necessary for "suspicion of child abuse" to constitute "reasonable suspicion". Data were analyzed for internal…

  15. Implications of the Virginia human papillomavirus vaccine mandate for parental vaccine acceptance.

    PubMed

    Pitts, Margaret Jane; Adams Tufts, Kimberly

    2013-05-01

    In 2009, Virginia became the first state in the United States to enact a school vaccine mandate for the human papillomavirus (HPV), putting it at the forefront of the national HPV vaccine mandate controversy. It is critical to explore the public response and sensemaking where the mandate has already been enacted. Thus, we conducted 8 focus group discussions among 33 Virginia parents to explore how they conceptualized the virus and vaccine and their responses to the mandate. Findings suggest that many parents are skeptical of and reluctant to follow a state-mandated vaccine requirement, choosing instead to opt out of the vaccine until they decide the time is right for their daughter and/or until they feel confident in their knowledge about the virus, vaccine, and the impetus for the mandate. Study results can inform future legislation among states considering HPV-related mandates and aid in the development of health-promotion materials within the context of a state mandate. PMID:23275459

  16. A Review of CBO's Activities in 2008 under the Unfunded Mandates Reform Act. A CBO Report

    ERIC Educational Resources Information Center

    Lex, Leo

    2009-01-01

    In this report, part of an annual series that began in 1997, the Congressional Budget Office (CBO) reviews its activities under the Unfunded Mandates Reform Act of 1995. The report covers public laws enacted and legislation considered by the Congress in 2008 that would impose federal mandates on state, local, or tribal governments or on the…

  17. Print News Coverage of School-Based Human Papillomavirus Vaccine Mandates

    ERIC Educational Resources Information Center

    Casciotti, Dana M.; Smith, Katherine C.; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C.

    2014-01-01

    Background: In 2007, legislation was proposed in 24 states and the District of Columbia for school-based human papillomavirus (HPV) vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding…

  18. Parent Involvement in the Special Education Eligibility Process: Implementation of Legal Mandates and Best Practices

    ERIC Educational Resources Information Center

    McEvoy, Cathleen K.

    2013-01-01

    School psychologists throughout New York State were surveyed regarding their schools' policies to include parents in the special education eligibility process related to legal mandates and best practices. Differences were found in the implementation of legal mandates compared to implementation of best practices. Location differences were…

  19. A Retrospective and an Analysis of Roles of Mandated Testing in Education Reform.

    ERIC Educational Resources Information Center

    Archbald, Douglas A.; Porter, Andrew C.

    The role and influence of mandated testing in educational reform are reviewed. Mandated testing refers to large-scale (districtwide or statewide) multiple-choice testing programs used for policy purposes of evaluation and accountability, which includes nationally normed standardized achievement tests and tests custom-developed to reflect state and…

  20. Adolescent Abortion and Mandated Parental Involvement: The Impact of Back Alley Laws on Young Women.

    ERIC Educational Resources Information Center

    Flinn, Susan; And Others

    This document notes that many states have passed, or are considering, laws that would mandate parental consent for, or notification of, a young woman's decision to obtain an abortion. Constructed in a question-and-answer format, the document then examines a number of issues concerned with such mandated parental involvement. It examines who is…

  1. 77 FR 35917 - Medicare Program; Medicare Secondary Payer and “Future Medicals”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... interest with respect to Medicare Secondary Payer (MSP) claims involving automobile and liability insurance...' compensation law or plan, automobile and liability insurance (including self-insurance), or no- fault...

  2. Single-payer health insurance systems: national myths and immovable mountains.

    PubMed Central

    Lightfoote, J. B.; Ragland, K. D.

    1996-01-01

    Leaders in both government and the health-care industry have strong and varied opinions regarding the present US health-care system, but concur that health-care financing and organization need restructuring. The single-payer system offers the best framework for improving health-care universality, delivery, quality, access, choice, and cost effectiveness. However, the single-payer alternative often is dismissed early in debates on health-care reform. Popular aversion to collective governmental funding of health-care costs and the economic interests of the management, insurance, information, and profit sectors of the health-care industry are the critical impediments to adoption of single-payer insurance systems. This article examines the psychosocial and economic obstacles that prevent development of an efficient and effective health-care system and preclude recognition of the single-payer system as the best answer to health-care reform. PMID:8648657

  3. Modified mandated choice for organ procurement.

    PubMed

    Chouhan, P; Draper, H

    2003-06-01

    Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means of increasing the procurement rate. In this paper, we meet the main objections to mandated choice (namely that it undermines autonomy and that mandated donation is preferable). We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation. PMID:12796435

  4. Great patient experiences can earn big payer bonuses.

    PubMed

    Luallin, Meryl D

    2014-01-01

    Although many healthcare providers have been railing against the stringent new requirements of the Affordable Care Act and the burdensome mandates from the Centers for Medicare & Medicaid Services, making simple improvements in patient satisfaction can require little to no expense and can result in increased dollars, as well as more satisfied patients. By following six simple steps, successful organizations have been able to transform their patients' experiences and raise satisfaction scores through a series of practical activities designed to assess the current environment, improve patient and employee/provider experience, and maintain the improvement gains. It doesn't always take money to make money. It's a matter of telling employees what the organization expects of them and holding them accountable. When the patient has a positive experience, everyone profits! PMID:25807613

  5. Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective.

    PubMed

    Silverman, Stuart; Agodoa, Irene; Kruse, Morgan; Parthan, Anju; Orwoll, Eric

    2015-01-01

    Purpose. To evaluate the cost-effectiveness of denosumab versus other osteoporotic treatments in older men with osteoporosis from a US payer perspective. Methods. A lifetime cohort Markov model previously developed for postmenopausal osteoporosis (PMO) was used. Men in the model were 78 years old, with a BMD T-score of -2.12 and a vertebral fracture prevalence of 23%. During each 6-month Markov cycle, patients could have experienced a hip, vertebral or nonhip, nonvertebral (NHNV) osteoporotic fracture, remained in a nonfracture state, remained in a postfracture state, or died. Background fracture risks, mortality rates, persistence rates, health utilities, and medical and drug costs were derived from published sources. Previous PMO studies were used for drug efficacy in reducing fracture risk. Lifetime expected costs and quality-adjusted life-years (QALYs) were estimated for denosumab, generic alendronate, risedronate, ibandronate, teriparatide, and zoledronate. Results. Denosumab had an incremental cost-effectiveness ratio (ICER) of $16,888 compared to generic alendronate and dominated all other treatments. Results were most sensitive to changes in costs of denosumab and the relative risk of hip fracture. Conclusion. Despite a higher annual treatment cost compared to other medications, denosumab is cost-effective compared to other osteoporotic treatments in older osteoporotic US men. PMID:26783494

  6. Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective

    PubMed Central

    Silverman, Stuart; Agodoa, Irene; Kruse, Morgan; Parthan, Anju; Orwoll, Eric

    2015-01-01

    Purpose. To evaluate the cost-effectiveness of denosumab versus other osteoporotic treatments in older men with osteoporosis from a US payer perspective. Methods. A lifetime cohort Markov model previously developed for postmenopausal osteoporosis (PMO) was used. Men in the model were 78 years old, with a BMD T-score of −2.12 and a vertebral fracture prevalence of 23%. During each 6-month Markov cycle, patients could have experienced a hip, vertebral or nonhip, nonvertebral (NHNV) osteoporotic fracture, remained in a nonfracture state, remained in a postfracture state, or died. Background fracture risks, mortality rates, persistence rates, health utilities, and medical and drug costs were derived from published sources. Previous PMO studies were used for drug efficacy in reducing fracture risk. Lifetime expected costs and quality-adjusted life-years (QALYs) were estimated for denosumab, generic alendronate, risedronate, ibandronate, teriparatide, and zoledronate. Results. Denosumab had an incremental cost-effectiveness ratio (ICER) of $16,888 compared to generic alendronate and dominated all other treatments. Results were most sensitive to changes in costs of denosumab and the relative risk of hip fracture. Conclusion. Despite a higher annual treatment cost compared to other medications, denosumab is cost-effective compared to other osteoporotic treatments in older osteoporotic US men. PMID:26783494

  7. Legislative Mandates and Financial Reporting.

    ERIC Educational Resources Information Center

    Bock, Almon C., II

    1983-01-01

    Asserts the importance of each school business official's responsibility to accurately report the school's financial situation to the state legislature. Uses Minnesota's 33 area vocational technical institutes to illustrate the application of statewide uniform financial accounting and reporting standards to Minnesota public school districts. (JBM)

  8. Patient-Reported Outcomes Are Changing the Landscape in Oncology Care: Challenges and Opportunities for Payers

    PubMed Central

    Zagadailov, Erin; Fine, Michael; Shields, Alan

    2013-01-01

    Background A patient-reported outcome (PRO) is a subjective report that comes from a patient without interpretation by a clinician. Because of the increasingly significant role of PROs in the development and evaluation of new medicines, the US Food and Drug Administration (FDA) issued a formal guidance to describe how PRO instruments will be reviewed and evaluated with respect to claims in approved medical product labeling. Meanwhile, PROs continue to appear in oncology clinical trials more frequently; however, it is unclear how payers and policymakers can use PRO data in the context of decision-making for cancer treatments. Objective The objective of this article is to discuss the challenges and opportunities of incorporating oncology-related PRO data into payer decision-making. Discussion Payer concerns with PRO instruments are often related to issues regarding measurement, relevance, quality, and interpretability of PROs. Payers may dismiss PROs that do not independently predict improved outcomes. The FDA guidance released in 2009 demonstrates, as evidenced by the case of ruxolitinib, how PRO questionnaires can be generated in a relevant, trustworthy, and meaningful way, which provides an opportunity for payers and policy decision makers to focus on how to use PRO data in their decision-making. This is particularly relevant in oncology, where a recent and sizable number of clinical trials include PRO measures. Conclusion As an increasing number of oncology medications enter the market with product labeling claims that contain PRO data, payers will need to better familiarize themselves with the opportunities associated with PRO questionnaires when making coverage decisions. PRO measures will continue to provide valuable information regarding the risk–benefit profile of novel agents. As such, PRO measures may provide evidence that should be considered in payers' decisions and discussions; however, the formal role of PROs and the pertinence of PROs in decision

  9. Primary Payer at DX: Issues with Collection and Assessment of Data Quality.

    PubMed

    Sherman, Recinda L; Williamson, Laura; Andrews, Patricia; Kahn, Amy

    2016-01-01

    An individual's access to health insurance influences the amount and type of health services a patient receives for prevention and treatment, and, ultimately, influences survival. The North American Association of Central Cancer Registries (NAACCR) Item #630, Primary Payer at DX, is a required field intended to document health insurance status for the purpose of supporting patterns-of-care studies and other research. However, challenges related to the uniformity of collection and availability of data needed to populate this field diminish the value of the Primary Payer at DX data. A NAACCR taskforce worked on issues surrounding the collection of Primary Payer at DX; including proposing a crosswalk between Primary Payer at DX and the new Public Health Payment Typology standard, often available in hospital discharge databases. However, there are issues with compatibility between coding systems, intent of data collection, timelines for coding insurance, and changes in insurance coverage (partly due to the Affordable Care Act) that continue to complicate the collection and use of Primary Payer at DX data. PMID:27556850

  10. State Test Programs Mushroom as NCLB Mandate Kicks in: Nearly Half of States Are Expanding Their Testing Programs to Additional Grades This School Year to Comply with the Federal No Child Left Behind Act

    ERIC Educational Resources Information Center

    Olson, Lynn

    2005-01-01

    Twenty-three states are expanding their testing programs to additional grades this school year to comply with the federal No Child Left Behind Act. In devising the new tests, most states have defied predictions and chosen to go beyond multiple-choice items, by including questions that ask students to construct their own responses. But many state…

  11. Ethanol mandate thrown out by appeals court

    SciTech Connect

    Begley, R.

    1995-05-10

    In a victory for the oil industry, a federal appeals court has overturned EPA`s mandate for ethanol use in reformulated gasoline (REG), saying the agency lacks authority to require 30% of the oxygenate market be reserved for ethanol. EPA says the ruling does not prevent ethanols use in RFG - {open_quotes}It only says that EPA cannot dictate the recipe.{close_quotes} Charles DiBona, president of the American Petroleum Institute (API), says {open_quotes}API and its member companies are not opposed to the use of ethanol as an oxygenate. We oppose this illegal mandate.{close_quotes} Urvan Sternfels, president of the National Petroleum Refiners Association, says, {open_quotes}Mandating market shares for any product is unsound economic policy.{close_quotes} The two trade groups led the legal battle against the ethanol requirement.

  12. Forensic evaluations and mandated reporting of child abuse.

    PubMed

    Kapoor, Reena; Zonana, Howard

    2010-01-01

    Statutes requiring physicians to report suspected cases of child abuse create a potential conflict for psychiatrists working in the forensic setting. What happens in the case in which a forensic psychiatrist, during the course of an evaluation requested by a defense attorney, learns about child abuse perpetrated by the evaluee? A complicated legal, ethics-related, and interpersonal dilemma emerges. Reporting the abuse may contribute directly to further legal harm to the evaluee and place a strain on the relationship with the attorney. However, not reporting the abuse potentially involves ignoring a legal mandate and risking further harm to a child. This article first reviews mandated reporting statutes across the states. Next, the arguments for and against reporting are outlined. Existing solutions to the problem are reviewed, and several alternative solutions are explored. Finally, an approach to negotiating the dilemma that can be used by forensic psychiatrists in practice is suggested. PMID:20305075

  13. The National Oncology Working Group (NOW) initiative: payer and provider collaborations in oncology benefits management.

    PubMed

    Soper, Aileen M; Reeder, C E; Brown, Loreen M; Stojanovska, Ana; Lennert, Barbara J

    2010-04-01

    Payers recognize the need to expand benefits management for oncology but struggle to find effective solutions amid the complexity of available therapies and skepticism from oncologists, who are facing their own set of economic pressures. An effort called the National Oncology Working Group (NOW) Initiative is trying to change the sometimes adversarial relationship between payers and oncologists through a collaborative model. The group, which is supported by pharmaceutical manufacturer sanofi-aventis, is developing patient-centered strategies for successful and sustainable oncology benefits management. The focus includes finding consensus between payers and providers and devising solutions for oncology management such as decreasing variability of cancer care and improving end-of-life care for patients with terminal illness. NOW is designing tools that will be tested in small-scale regional demonstration projects, which NOW participants anticipate will set an example for successful oncology benefits management that can be replicated and expanded. PMID:20370311

  14. Proposal for Canadian-style single-payer health care receives cool reception in US.

    PubMed Central

    Korcok, M

    1995-01-01

    Is health care reform dead in the US? It may be, if the reception given President Clinton's reform plan and a proposal for a single-payer program in California is any indication. There has been a dramatic move to the right south of the border, where people have lined up to oppose "big government" and additional government programs. Still, American proponents of a single-payer program similar to Canada's insist that the battle for reform is not yet over. Images p407-a PMID:7828107

  15. Improving state Medicaid policies with comparative effectiveness research: a key role for academic health centers.

    PubMed

    Zerzan, Judy T; Gibson, Mark; Libby, Anne M

    2011-06-01

    After the Patient Protection and Affordable Care Act is fully implemented, Medicaid will be the largest single health care payer in the United States. Each U.S. state controls the size and scope of the medicine benefit beyond the federally mandated minimum; however, regulations that require balanced budgets and prohibit deficit spending limit each state's control. In a recessionary environment with reduced revenue, state Medicaid programs operate under a fixed or shrinking budget. Thus, the state Medicaid experience of providing high-quality care under explicit financial limits can inform Medicare and private payers of measures that control per-capita costs without adversely affecting health outcomes. The academic medicine community must play an expanded role in filling evidence gaps in order to continuously improve health policy making among U.S. states. The Drug Effectiveness Review Project and the Medicaid Evidence-based Decisions Project are two multistate Medicaid collaborations that leverage academic health center researchers' comparative effectiveness research (CER) projects to answer policy-relevant research questions. The authors of this article highlight how academic medicine can support states' health policies through CER and how CER-driven benefit-design choices can help states meet their cost and quality needs. PMID:21512359

  16. Effectiveness of an Electronic Booster Session Delivered to Mandated Students.

    PubMed

    Linowski, Sally A; DiFulvio, Gloria T; Fedorchak, Diane; Puleo, Elaine

    2016-01-01

    College student drinking continues to be a problem in the United States. Students who have violated campus alcohol policy are at particularly high risk for dangerous drinking. While Brief Alcohol Screening and Intervention for College Students (BASICS) has been found to be an effective strategy in reducing high-risk drinking and associated consequences, questions remain about ways to further reduce risk or sustain changes associated with a face-to face intervention. The purpose of this study was to assess the effectiveness of a computer-delivered personalized feedback (electronic booster) delivered to policy violators who completed a mandated BASICS program. At 3-month post-intervention, 346 participants (60.4% male and 39.6% female) were randomized to one of two conditions: assessment only (n = 171) or electronic booster feedback (n = 175). Follow-up assessments were given to all participants at 3, 6, and 12-month post-initial intervention. Both groups showed reductions in drinking after the in-person BASICS intervention, but no additional reductions were seen with the addition of an electronic booster session. Findings suggest that although brief motivational interventions delivered in person to mandated students have been shown to be effective with mandated students, there is no additional benefit from an electronic booster session delivered 3-month post-intervention for this population. PMID:26857563

  17. 78 FR 75304 - Medicare Program; Medicare Secondary Payer and Certain Civil Money Penalties

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-11

    ... either the Office of Inspector General (OIG) or CMS (See the October 20, 1994 (58 FR 52967) notice titled...; Medicare Secondary Payer and Certain Civil Money Penalties AGENCY: Centers for Medicare & Medicaid Services... rulemaking (ANPRM) solicits public comment on specific practices for which civil money penalties (CMPs)...

  18. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment when Medicare is not primary payer. 417.528 Section 417.528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  19. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Payment when Medicare is not primary payer. 417.528 Section 417.528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  20. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment when Medicare is not primary payer. 417.528 Section 417.528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS,...

  1. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Payment when Medicare is not primary payer. 417.528 Section 417.528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  2. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Payment when Medicare is not primary payer. 417.528 Section 417.528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS,...

  3. Quality of care in single-payer and multipayer health systems.

    PubMed

    Feldman, Roger

    2009-08-01

    In this article, I argue that unregulated markets will not find the right level of health care quality but that at the same time it is not clear that single-payer systems will do any better. My perspective combines the economic theory of public goods and the institutional payment arrangements found in many single-payer systems. If, as I believe, health care quality is a public good, it will be underprovided in a multipayer system. Single-payer systems often allocate a fixed budget to health care professionals or administrators and give them considerable discretion in determining quality as well as quantity of service. With care being free or almost free at the point of use, patients will demand more services than administrators want to provide. The result is rationing by waiting -- which should be present in all such systems and is present in most of them. I develop several implications of the theory and an agenda for future research on quality of care in single-payer and multipayer health systems. PMID:19633227

  4. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate. The... light duty vehicle (regardless of the model year of manufacture), capable of operating on...

  5. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate. The... light duty vehicle (regardless of the model year of manufacture), capable of operating on...

  6. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate. The... light duty vehicle (regardless of the model year of manufacture), capable of operating on...

  7. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate. The... light duty vehicle (regardless of the model year of manufacture), capable of operating on...

  8. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate. The... light duty vehicle (regardless of the model year of manufacture), capable of operating on...

  9. The effects of mandated health insurance benefits for autism on out-of-pocket costs and access to treatment.

    PubMed

    Chatterji, Pinka; Decker, Sandra L; Markowitz, Sara

    2015-01-01

    As of 2014, 37 states have passed mandates requiring many private health insurance policies to cover diagnostic and treatment services for autism spectrum disorders (ASDs). We explore whether ASD mandates are associated with out-of-pocket costs, financial burden, and cost or insurance-related problems with access to treatment among privately insured children with special health care needs (CSHCNs). We use difference-in-difference and difference-in-difference-in-difference approaches, comparing pre--post mandate changes in outcomes among CSHCN who have ASD versus CSHCN other than ASD. Data come from the 2005 to 2006 and the 2009 to 2010 waves of the National Survey of CSHCN. Based on the model used, our findings show no statistically significant association between state ASD mandates and caregivers' reports about financial burden, access to care, and unmet need for services. However, we do find some evidence that ASD mandates may have beneficial effects in states in which greater percentages of privately insured individuals are subject to the mandates. We caution that we do not study the characteristics of ASD mandates in detail, and most ASD mandates have gone into effect very recently during our study period. PMID:25893237

  10. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule. (a..., when the mandated acquisition percentage of alternative fuel vehicles is applied to the number of...

  11. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule. (a..., when the mandated acquisition percentage of alternative fuel vehicles is applied to the number of...

  12. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule. (a..., when the mandated acquisition percentage of alternative fuel vehicles is applied to the number of...

  13. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule. (a..., when the mandated acquisition percentage of alternative fuel vehicles is applied to the number of...

  14. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule. (a..., when the mandated acquisition percentage of alternative fuel vehicles is applied to the number of...

  15. Legislating Clinical Practice: Counselor Responses to an Evidence-Based Practice Mandate

    PubMed Central

    Rieckmann, Traci; Bergmann, Luke; Rasplica, Caitlin

    2013-01-01

    The demand to connect research findings with clinical practice for patients with substance use disorders has accelerated state and federal efforts focused on implementation of evidence-based practices (EBPs). One unique state driven strategy is Oregon’s Evidence-Based Practice mandate, which ties state funds to specific treatment practices. Clinicians play an essential role in implementation of shifts in practice patterns and use of EBPs, but little is understood about how legislative efforts impact clinicians’ sentiments and decision-making. This study presents longitudinal data from focus groups and interviews completed during the planning phase (n = 66) and early implementation of the mandate (n = 73) to investigate provider attitudes toward this policy change. Results reflect three emergent themes: (1) concern about retaining individualized treatment and clinical latitude, (2) distrust of government involvement in clinical care, and (3) the need for accountability and credibility for the field. We conclude with recommendations for state agencies considering EBP mandates. PMID:22185037

  16. Legislating clinical practice: counselor responses to an evidence-based practice mandate.

    PubMed

    Rieckmann, Traci; Bergmann, Luke; Rasplica, Caitlin

    2011-09-01

    The demand to connect research findings with clinical practice for patients with substance use disorders has accelerated state and federal efforts focused on implementation of evidence-based practices (EBPs). One unique state driven strategy is Oregon's Evidence-Based Practice mandate, which ties state funds to specific treatment practices. Clinicians play an essential role in implementation of shifts in practice patterns and use of EBPs, but little is understood about how legislative efforts impact clinicians' sentiments and decision-making. This study presents longitudinal data from focus groups and interviews completed during the planning phase (n = 66) and early implementation of the mandate (n = 73) to investigate provider attitudes toward this policy change. Results reflect three emergent themes: (1) concern about retaining individualized treatment and clinical latitude, (2) distrust of government involvement in clinical care, and (3) the need for accountability and credibility for the field. We conclude with recommendations for state agencies considering EBP mandates. PMID:22185037

  17. A single-payer system in Jackson Hole clothing.

    PubMed

    Enthoven, A C; Singer, S J

    1994-01-01

    President Clinton's Health Security Act relies on government regulation, not market forces, to control costs. The act creates an entitlement to comprehensive benefits and places the federal budget at risk for total health care costs in order to achieve universal coverage; it creates a system of new state purchasing monopsonies; and it attempts to control costs with price controls on health plan premiums, set and administered by a National Health Board that would be part of the executive branch, not insulated from political considerations. We believe there is a better way. PMID:8188160

  18. Legal Briefing: Mandated Reporters and Compulsory Reporting Duties.

    PubMed

    Pope, Thaddeus Mason

    2016-01-01

    This issue's "Legal Briefing" column, one product of a Greenwall Foundation grant, reviews recent developments concerning compulsory reporting duties. Most licensed clinicians in the United States are "mandated reporters." When these clinicians discover certain threats to the safety of patients or the public, they are legally required to report that information to specified government officials. Over the past year, several states have legislatively expanded the scope of these reporting duties. In other states, new court cases illustrate the vigorous enforcement of already existing duties. I have organized all these legal developments into the following eight categories: 1. Overview of Mandatory Reporting Duties 2. Controversy over the Benefits of Mandatory Reporting 3. New and Expanded Duties to Report 4. Criminal Penalties for Failing to Report 5. Civil Liability for Failing to Report 6. Disciplinary Penalties for Failing to Report 7. Legal Immunity for Good-Faith Reporting 8. Protection against Employers' Retaliation. PMID:27045312

  19. Single-payer, defined contribution or portable HRAs: will market-based models prevail?

    PubMed

    Gupta, Amit K

    2003-01-01

    Rising healthcare costs have created a crisis situation in employee health benefits. For the first time in a decade, the call for a single-payer healthcare system has been renewed. Although the single-payer system might help expand access to care and reduce administrative costs, the potential costs and bureaucracy make its implementation unrealistic. Consumer-centric health benefit models such as defined contribution and portable HRAs are the first attempts by the private sector to involve consumers in the healthcare decision process. Portable HRAs, which treat health benefits as portable assets to be managed and saved over a lifetime, have the potential to reduce employer costs while improving the quality and continuity of care, with equal access to care for all. PMID:12968441

  20. Distinctions in Disclosure: Mandated Informed Consent in Abortion and ART.

    PubMed

    Daar, Judith

    2015-01-01

    Enactment of mandated pre-procedure disclosures in abortion and assisted reproductive technology (ART) services has swelled in recent years. Calls to equally regard these mandates as neutral tools in furtherance of patient protection fail to acknowledge key substantive and structural differences in these reproduction-affecting mandates. While ART mandates permit physicians to use their medical judgment to protect presumptively vulnerable egg donors and gestational carriers, abortion disclosures impart scientifically suspect messaging aimed at dissuading women from pursuing pregnancy termination. These and other distinctions counsel in favor of regarding and analyzing abortion and ART mandated disclosures as separate and distinguishable informed consent tools. PMID:26242946

  1. Estimating Nitrogen Load Resulting from Biofuel Mandates.

    PubMed

    Alshawaf, Mohammad; Douglas, Ellen; Ricciardi, Karen

    2016-01-01

    The Energy Policy Act of 2005 and the Energy Independence and Security Act (EISA) of 2007 were enacted to reduce the U.S. dependency on foreign oil by increasing the use of biofuels. The increased demand for biofuels from corn and soybeans could result in an increase of nitrogen flux if not managed properly. The objectives of this study are to estimate nitrogen flux from energy crop production and to identify the catchment areas with high nitrogen flux. The results show that biofuel production can result in an increase of nitrogen flux to the northern Gulf of Mexico from 270 to 1742 thousand metric tons. Using all cellulosic (hay) ethanol or biodiesel to meet the 2022 mandate is expected to reduce nitrogen flux; however, it requires approximately 25% more land when compared to other scenarios. Producing ethanol from switchgrass rather than hay results in three-times more nitrogen flux, but requires 43% less land. Using corn ethanol for 2022 mandates is expected to have double the nitrogen flux when compared to the EISA-specified 2022 scenario; however, it will require less land area. Shifting the U.S. energy supply from foreign oil to the Midwest cannot occur without economic and environmental impacts, which could potentially lead to more eutrophication and hypoxia. PMID:27171101

  2. Estimating Nitrogen Load Resulting from Biofuel Mandates

    PubMed Central

    Alshawaf, Mohammad; Douglas, Ellen; Ricciardi, Karen

    2016-01-01

    The Energy Policy Act of 2005 and the Energy Independence and Security Act (EISA) of 2007 were enacted to reduce the U.S. dependency on foreign oil by increasing the use of biofuels. The increased demand for biofuels from corn and soybeans could result in an increase of nitrogen flux if not managed properly. The objectives of this study are to estimate nitrogen flux from energy crop production and to identify the catchment areas with high nitrogen flux. The results show that biofuel production can result in an increase of nitrogen flux to the northern Gulf of Mexico from 270 to 1742 thousand metric tons. Using all cellulosic (hay) ethanol or biodiesel to meet the 2022 mandate is expected to reduce nitrogen flux; however, it requires approximately 25% more land when compared to other scenarios. Producing ethanol from switchgrass rather than hay results in three-times more nitrogen flux, but requires 43% less land. Using corn ethanol for 2022 mandates is expected to have double the nitrogen flux when compared to the EISA-specified 2022 scenario; however, it will require less land area. Shifting the U.S. energy supply from foreign oil to the Midwest cannot occur without economic and environmental impacts, which could potentially lead to more eutrophication and hypoxia. PMID:27171101

  3. UnitedHealthcare experience illustrates how payers can enable patient engagement.

    PubMed

    Sandy, Lewis G; Tuckson, Reed V; Stevens, Simon L

    2013-08-01

    Patient engagement is crucial to better outcomes and a high-performing health system, but efforts to support it often focus narrowly on the role of physicians and other care providers. Such efforts miss payers' unique capabilities to help patients achieve better health. Using the experience of UnitedHealthcare, a large national payer, this article demonstrates how health plans can analyze and present information to both patients and providers to help close gaps in care; share detailed quality and cost information to inform patients' choice of providers; and offer treatment decision support and value-based benefit designs to help guide choices of diagnostic tests and therapies. As an employer, UnitedHealth Group has used these strategies along with an "earn-back" program that provides positive financial incentives through reduced premiums to employees who adopt healthful habits. UnitedHealth's experience provides lessons for other payers and for Medicare and Medicaid, which have had minimal involvement with demand-side strategies and could benefit from efforts to promote activated beneficiaries. PMID:23918489

  4. The Mandate Mystery: How Mandates Impact School Districts Physically and Financially

    ERIC Educational Resources Information Center

    Dorris, Denae

    2010-01-01

    Renovation and construction of Texas public schools is occurring at a rapid pace and at high prices. Business continues to blossom in the area of school construction. Several factors influence the need to renovate or construct schools, but the impact curriculum mandates have on school construction is seldom explored. This study investigated the…

  5. Mandated data archiving greatly improves access to research data.

    PubMed

    Vines, Timothy H; Andrew, Rose L; Bock, Dan G; Franklin, Michelle T; Gilbert, Kimberly J; Kane, Nolan C; Moore, Jean-Sébastien; Moyers, Brook T; Renaut, Sébastien; Rennison, Diana J; Veen, Thor; Yeaman, Sam

    2013-04-01

    The data underlying scientific papers should be accessible to researchers both now and in the future, but how best can we ensure that these data are available? Here we examine the effectiveness of four approaches to data archiving: no stated archiving policy, recommending (but not requiring) archiving, and two versions of mandating data deposition at acceptance. We control for differences between data types by trying to obtain data from papers that use a single, widespread population genetic analysis, structure. At one extreme, we found that mandated data archiving policies that require the inclusion of a data availability statement in the manuscript improve the odds of finding the data online almost 1000-fold compared to having no policy. However, archiving rates at journals with less stringent policies were only very slightly higher than those with no policy at all. We also assessed the effectiveness of asking for data directly from authors and obtained over half of the requested datasets, albeit with ∼8 d delay and some disagreement with authors. Given the long-term benefits of data accessibility to the academic community, we believe that journal-based mandatory data archiving policies and mandatory data availability statements should be more widely adopted. PMID:23288929

  6. Eight reasons payer interoperability and data sharing are essential in ACOs. Interoperability standards could be a prerequisite to measuring care.

    PubMed

    Mookencherry, Shefali

    2012-01-01

    It makes strategic and business sense for payers and providers to collaborate on how to take substantial cost out of the healthcare delivery system. Acting independently, neither medical groups, hospitals nor health plans have the optimal mix of resources and incentives to significantly reduce costs. Payers have core assets such as marketing, claims data, claims processing, reimbursement systems and capital. It would be cost prohibitive for all but the largest providers to develop these capabilities in order to compete directly with insurers. Likewise, medical groups and hospitals are positioned to foster financial interdependence among providers and coordinate the continuum of patient illnesses and care settings. Payers and providers should commit to reasonable clinical and cost goals, and share resources to minimize expenses and financial risks. It is in the interest of payers to work closely with providers on risk-management strategies because insurers need synergy with ACOs to remain cost competitive. It is in the interest of ACOs to work collaboratively with payers early on to develop reasonable and effective performance benchmarks. Hence, it is essential to have payer interoperability and data sharing integrated in an ACO model. PMID:22352172

  7. A constructive Indian country response to the evidence-based program mandate.

    PubMed

    Walker, R Dale; Bigelow, Douglas A

    2011-01-01

    Over the last 20 years governmental mandates for preferentially funding evidence-based "model" practices and programs has become doctrine in some legislative bodies, federal agencies, and state agencies. It was assumed that what works in small sample, controlled settings would work in all community settings, substantially improving safety, effectiveness, and value-for-money. The evidence-based "model" programs mandate has imposed immutable "core components," fidelity testing, alien programming and program developers, loss of familiar programs, and resource capacity requirements upon tribes, while infringing upon their tribal sovereignty and consultation rights. Tribal response in one state (Oregon) went through three phases: shock and rejection; proposing an alternative approach using criteria of cultural appropriateness, aspiring to evaluability; and adopting logic modeling. The state heard and accepted the argument that the tribal way of knowing is different and valid. Currently, a state-authorized tribal logic model and a review panel process are used to approve tribal best practices for state funding. This constructive response to the evidence-based program mandate elevates tribal practices in the funding and regulatory world, facilitates continuing quality improvement and evaluation, while ensuring that practices and programs remain based on local community context and culture. This article provides details of a model that could well serve tribes facing evidence-based model program mandates throughout the country. PMID:22400457

  8. The economics of regulatory mandates on the HMO market.

    PubMed

    Encinosa, W

    2001-01-01

    Recently proposed HMO regulations have involved mandates of two forms: (1) minimum quality standards, and (2) mandated increases in access to speciality care. I show that piecemeal regulation, which uses only one of either mandate (1) or (2), may decrease welfare for all HMO consumers. Under full regulation using both (1) and (2), if the minimum standard is set too low, say, due to political bargaining, a floor-to-ceiling effect occurs. This involves HMOs setting quality at the minimum standard, even when their quality would be above the standard in an unregulated market. Finally, I show how premiums may either increase or decrease under a mandate. PMID:11148873

  9. HAC-POA Policy Effects on Hospitals, Other Payers, and Patients

    PubMed Central

    Sorensen, Asta; Jarrett, Nikki; Tant, Elizabeth; Bernard, Shulamit; McCall, Nancy

    2014-01-01

    Background Prior to the implementation of the Hospital-Acquired Condition-Present on Admission (HAC-POA) payment policy, concerns regarding its potential impact were raised by a number of organizations and individuals. The purpose of this study was to explore direct and indirect effects of the HAC-POA payment policy on hospitals, patients, and other payers during the policy’s first 3 years of implementation. Methods The study included semi-structured telephone interviews with representatives of national organizations, hospitals, patient advocacy organizations, and other payers. Interview notes were coded using QSR NVivo qualitative analysis software using inductive and deductive qualitative analysis techniques. We conducted interviews with 106 individuals representing 56 organizations. Hospital staff included physicians, nurses, patient safety officers, coders, and finance, senior management, and information management staff. Individuals from other organizations represented leadership positions. Results Key changes to hospitals included: cultural shifts involving attention, commitment, and support from hospital leadership for patient safety; hiring new staff to assure the accuracy of clinical documentation and POA oversight structures; increased time burden for physicians, nurses, and coders; need to upgrade or purchase new software; and need to collaborate with hospital departments or staff that did not interface directly in the past. The policy was adopted by a majority of other payers, although the list of conditions and payment penalties varies. The HAC-POA policy is invisible to patients; therefore, the presence or lack of unintended consequences to patients cannot be fully assessed at this time. Understanding of policy effects to all stakeholders is important for maximizing its successful implementation and desired impact. PMID:25343058

  10. Managed competition. An analysis of consumer concerns. Single-Payer Coalition for Health Security.

    PubMed

    1993-01-01

    This analysis of managed competition was written by the Single-Payer Coalition for Health Security, a broad-based coalition of groups representing for the most part consumers of health care, including American Public Health Association; Church Women United; Citizen Action; Consumers Union; National Association of Social Workers; National Council of Senior Citizens; Neighbor to Neighbor; NETWORK: A National Catholic Social Justice Lobby; Oil, Chemical & Atomic Workers International Union; Older Women's League; Physicians for a National Health Program; Public Citizen; United Cerebral Palsy Associations; and United Church of Christ. What follows is a substantial excerpt from their working paper, issued in January 1993. PMID:10126171

  11. Managing biotechnology in a network-model health plan: a U.S. private payer perspective.

    PubMed

    Watkins, John B; Choudhury, Sanchita Roy; Wong, Ed; Sullivan, Sean D

    2006-01-01

    Emerging biotechnology poses challenges to payers, including access, coverage, reimbursement, patient selection, and affordability. Premera Blue Cross, a private regional health plan, developed an integrated cross-functional approach to managing biologics, built around a robust formulary process that is fast, flexible, fair, and transparent to stakeholders. Results are monitored by cost and use reporting from merged pharmacy and medical claims. Utilization management and case management strategies will integrate with specialty pharmacy programs to improve outcomes and cost-effectiveness. Creative approaches to provider reimbursement can align providers' incentives with those of the plan. Redesign of member benefits can also encourage appropriate use of biotechnology. PMID:16966732

  12. Mandated Coverage of Preventive Care and Reduction in Disparities: Evidence From Colorectal Cancer Screening

    PubMed Central

    Kapinos, Kandice A.

    2015-01-01

    Objectives. We identified correlates of racial/ethnic disparities in colorectal cancer screening and changes in disparities under state-mandated insurance coverage. Methods. Using Behavioral Risk Factor Surveillance System data, we estimated a Fairlie decomposition in the insured population aged 50 to 64 years and a regression-adjusted difference-in-difference-in-difference model of changes in screening attributable to mandates. Results. Under mandated coverage, blood stool test (BST) rates increased among Black, Asian, and Native American men, but rates among Whites also increased, so disparities did not change. Endoscopic screening rates increased by 10 percentage points for Hispanic men and 3 percentage points for non-Hispanic men. BST rates fell among Hispanic relative to non-Hispanic men. We found no changes for women. However, endoscopic screening rates improved among lower income individuals across all races and ethnicities. Conclusions. Mandates were associated with a reduction in endoscopic screening disparities only for Hispanic men but may indirectly reduce racial/ethnic disparities by increasing rates among lower income individuals. Findings imply that systematic differences in insurance coverage, or health plan fragmentation, likely existed without mandates. These findings underscore the need to research disparities within insured populations. PMID:25905835

  13. Who are the donors in organ donation? The family's perspective in mandated choice.

    PubMed

    Klassen, A C; Klassen, D K

    1996-07-01

    Evidence that families requested to permit organ donation refuse half the time has led to proposals for mandated choice. Under mandated choice, a person's donation wishes would be collected and retrieved at death, and requests to families would be avoided. There are both ethical and logistic problems with mandated choice. The view of the family should be respected in organ requests, even when patient wishes are known. Public sentiment against overriding family wishes could cause low rates of pro-donation registration. Caregivers have usually refused to take organs when families oppose donation. Logistic issues with mandated choice include the cost and complexity of maintaining a national database on donors and the enforcement of registration. No such database of adults currently exists, even for tax purposes. Two states that have mandated choice programs through departments of motor vehicles report relatively low number of pro-donation registrants compared with nondonors or undecided persons. Public education and voluntary donor identification hold more potential to increase donation. PMID:8644991

  14. A Qualitative Case Study of Teachers' Perceptions of Professional Learning through Mandated Collaboration

    ERIC Educational Resources Information Center

    Wilt, Barbara C.

    2016-01-01

    Teacher collaboration is a school improvement priority that has the potential to positively impact student learning by building the capacity of teachers. In some states, teacher collaboration is mandated by legislation. The literature indicates that policy-driven collaboration in a top-down approach results in unintentional consequences and…

  15. California Secondary School Physical Education Teachers' Attitudes toward the Mandated Use of the Fitnessgram

    ERIC Educational Resources Information Center

    Ferguson, Robert H.; Keating, Xiaofen Deng; Guan, Jianmin; Chen, Li; Bridges, Dwan M.

    2007-01-01

    This study aimed to determine how California secondary physical education teachers perceive the state mandated youth fitness testing for the 5th, 7th, and 9th grades using Fitnessgram. The participants were secondary school physical education teachers (N = 323). A previously validated attitudinal instrument (Keating & Silverman, 2004a) was used to…

  16. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  17. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  18. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  19. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  20. 10 CFR 490.201 - Alternative fueled vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Alternative fueled vehicle acquisition mandate schedule. 490.201 Section 490.201 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory State Fleet Program § 490.201 Alternative fueled vehicle acquisition...

  1. Utilizing Online Education in Florida to Meet Mandated Class Size Limitations

    ERIC Educational Resources Information Center

    Mattox, Kari Ann

    2012-01-01

    With the passage of a state constitutional amendment in 2002, Florida school districts faced the challenge of meeting class size mandates in core subjects, such as mathematics, English, and science by the 2010-2011 school year, or face financial penalties. Underpinning the amendment's goals was the argument that smaller classes are more effective…

  2. Impact of Nurse Staffing Mandates on Safety-Net Hospitals: Lessons from California

    PubMed Central

    McHugh, Matthew D; Brooks Carthon, Margo; Sloane, Douglas M; Wu, Evan; Kelly, Lesly; Aiken, Linda H

    2012-01-01

    Context California is the first and only state to implement a patient-to-nurse ratio mandate for hospitals. Increasing nurse staffing is an important organizational intervention for improving patient outcomes. Evidence suggests that staffing improved in California hospitals after the mandate was enacted, but the outcome for hospitals bearing a disproportionate share of uncompensated care—safety-net hospitals—remains unclear. One concern was that California's mandate would burden safety-net hospitals without improving staffing or that hospitals would reduce their skill mix, that is, the proportion of registered nurses of all nursing staff. We examined the differential effect of California's staffing mandate on safety-net and non-safety-net hospitals. Methods We used a time-series design with Annual Hospital Disclosure data files from the California Office of Statewide Health Planning and Development (OSHPD) for the years 1998 to 2007 to assess differences in the effect of California's mandate on staffing outcomes in safety-net and non-safety-net hospitals. Findings The mandate resulted in significant staffing improvements, on average nearly a full patient per nurse fewer (−0.98) for all California hospitals. The greatest effect was in those hospitals with the lowest staffing levels at the outset, both safety-net and non-safety-net hospitals, as the legislation intended. The mandate led to significantly improved staffing levels for safety-net hospitals, although there was a small but significant difference in the effect on staffing levels of safety-net and non-safety-net hospitals. Regarding skill mix, a marginally higher proportion of registered nurses was seen in non-safety-net hospitals following the mandate, while the skill mix remained essentially unchanged for safety-net hospitals. The difference between the two groups of hospitals was not significant. Conclusions California's mandate improved staffing for all hospitals, including safety-net hospitals

  3. Cost of a lymphedema treatment mandate-10 years of experience in the Commonwealth of Virginia.

    PubMed

    Weiss, Robert

    2016-12-01

    Treatment of chronic illness accounts for over 90 % of Medicare spending. Chronic lymphedema places over 3 million Americans at risk of recurrent cellulitis. Health insurers and legislators have taken an active role in fighting attempts to mandate the treatment of lymphedema for fear that provision of the physical therapy and compression materials would result in large and uncontrollable claim costs. The author knows of no open source of lymphedema treatment cost data based on population coverage or claims. Published studies compare cost of treatment versus cost of non-treatment for a select group of lymphedema patients. They do not provide the data necessary for insurance underwriters' estimations of expected claim costs for a larger general population with a range of severities, or for legislators' evaluations of the costs of proposed mandates to cover treatment of lymphedema according to current medical standards. These data are of interest to providers, advocates and legislators in Canada, Australia and England as well as the U.S.The Commonwealth of Virginia has had a lymphedema treatment mandate since 2004. Reported data for 2004-2013, representing 80 % of the Virginia healthcare insurance market, contains claims and utilization data and claims-based estimates of the premium impact of its lymphedema mandate. The average actual annual lymphedema claim cost was $1.59 per individual contract and $3.24 per group contract for the years reported, representing 0.053 and 0.089 % of average total claims. The estimated premium impact ranged 0.00-0.64 % of total average premium for all mandated coverage contracts. In this study actual costs are compared with pre-mandate state mandate commission estimates for proposed lymphedema mandates from Virginia, Massachusetts and California.Ten years of insurance experience with a lymphedema treatment mandate in Virginia shows that costs of lymphedema treatment are an insignificant part of insured healthcare costs, and that

  4. What can be gained from increased early-stage interaction between regulators, payers and the pharmaceutical industry?

    PubMed

    Wonder, Michael

    2014-08-01

    New medicines are the lifeblood of the global innovative pharmaceutical industry. Developments in genomics, proteomics, immunology and cellular biology are set to promise a plethora of novel targets for the industry to create and develop innovative new medicines. For a new medicine to fulfill its therapeutic and commercial potential (i.e., successful market access), it is now simply no longer a matter of its creator/developer generating evidence to demonstrate its quality, safety and efficacy to a standard expected by those responsible for making a decision on its marketing authorization ('regulators'). Nowadays, the successful market access of a new medicine not only requires market authorisation with an acceptable (i.e., competitive) label, but also that those responsible for making a decision on whether or not it is worth paying for (i.e., independent appraisal committees who advise payers as well as payers themselves; the term 'payers' has been used as an umbrella term to capture both groups) have the necessary clinical and other evidence they need to make a timely and favorable reimbursement determination at the proposed price. Typically this means that the clinical evidence for a development compound's that is available at the end of its Phase III clinical trial program to demonstrate its therapeutic value is both strong and relevant to the decisions payers are called upon to make. This poses strategic and operational challenges for the global pharmaceutical industry because the clinical evidence needs of the payers differ both qualitatively and quantitatively from those of the regulators. PMID:24820934

  5. WHY DO AMERICANS STILL NEED SINGLE-PAYER HEALTH CARE AFTER MAJOR HEALTH REFORM?

    PubMed

    Chaufan, Claudia

    2015-01-01

    Many observers have considered the Affordable Care Act (ACA) the most significant health care overhaul since Medicare, in the tradition of Great Society programs. And yet, in opinion polls, Americans across the political spectrum repeatedly express their strong support for Medicare, alongside their disapproval of the ACA. This feature of American public opinion is often seen as a contradiction and often explained as "incoherence," a mere feature of Americans' "muddled mind." In this article I argue that what explains this seeming contradiction is not any peculiarity of Americans' psychology but rather the grip of the corporate class on the political process and on key social institutions (e.g., mass media, judiciary), no less extraordinary today than in the past. I also argue that ordinary Americans, like millions of their counterparts in the world, would eagerly support a single-payer national health program that speaks to their interests rather than to those of the 1 percent. I will describe the ACA, compare it to Medicare, explain the concept of single payer, and conclude that the task is not to persuade presumably recalcitrant Americans to support the ACA but rather to organize a mass movement to struggle for what is right and join the rest of the world in the road toward health justice. PMID:26460454

  6. Policy Implications of First-Dollar Coverage: A Qualitative Examination from the Payer Perspective

    PubMed Central

    Shortridge, Emily F.; Moore, Jonathan R.; Whitmore, Heidi; O'Grady, Michael J.; Shen, Angela K.

    2011-01-01

    Objectives Immunization against potentially life-threatening illnesses for children and adults has proved to be one of the great public health successes of the 20th century and is extremely cost-effective. The Patient Protection and Affordable Care Act includes a number of provisions to increase coverage and access to immunizations for the consumer, including a provision for health plans to cover all Advisory Committee on Immunization Practices-recommended vaccines at first dollar, or without cost sharing. In this study, we examined payers' perspectives on first-dollar coverage of vaccines and strategies to improve vaccination rates. Methods This was a qualitative study, using a literature review and semistructured expert interviews with payers. Results Four key themes emerged, including (1) the cost implications of the first-dollar change; (2) the importance of examining barriers to children, adolescents, and adults separately to focus interventions more strategically; (3) the importance of provider knowledge and education in increasing immunization; and (4) the effect of first-dollar coverage on those who decline vaccination for personal reasons. Conclusions We determined that, while reducing financial barriers through first-dollar coverage is an important first step to increasing immunization rates, there are structural and cultural barriers that also will require collaborative, strategic work among all vaccine stakeholders. PMID:21553668

  7. Discipline and Play with/in a Mandated Literacy Curriculum

    ERIC Educational Resources Information Center

    Kontovourki, Stavroula; Siegel, Marjorie

    2009-01-01

    In this article, the authors explore a young child's lived experience of discipline and play with/in a mandated balanced literacy curriculum. Mandating balanced literacy presents an interesting case of disciplining literacy because it is rooted in the progressive tradition of meaning-and-process pedagogies. As such, it avoids the most obvious…

  8. Mandated Disciplinary Counseling: Working Effectively with Challenging Clients

    ERIC Educational Resources Information Center

    Kiracofe, Norman M.; Buller, Allison E.

    2009-01-01

    Mandated disciplinary counseling has been a long-established practice for many college and university counseling centers. Although the practice is well established, practitioners continue to raise questions about its appropriateness and effectiveness. Student dynamics and other issues influencing the efficacy of mandated counseling are explored.…

  9. A Chronological History of Federal Fleet Actions and Mandates

    SciTech Connect

    2011-04-22

    This chronological history of Federal fleet actions and mandates provides a year-by-year timeline of the acts, amendments, executive orders, and other regulations that affect Federal fleets. The fleet actions and mandates included in the timeline span from 1988 to 2009.

  10. Chronological History of Federal Fleet Actions and Mandates (Brochure)

    SciTech Connect

    Not Available

    2011-04-01

    This chronological history of Federal fleet actions and mandates provides a year-by-year timeline of the acts, amendments, executive orders, and other regulations that affect Federal fleets. The fleet actions and mandates included in the timeline span from 1988 to 2009.

  11. Teaching to and beyond the Test: The Influence of Mandated Accountability Testing in One Social Studies Teacher's Classroom

    ERIC Educational Resources Information Center

    Neumann, Jacob

    2013-01-01

    Background/Context: The nature of the impact of state-mandated accountability testing on teachers' classroom practices remains contested. While many researchers argue that teachers change their teaching in response to mandated testing, others contend that the nature and degree of the impact of testing on teaching remains unclear. The research…

  12. Medicare Program; Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal. Final rule.

    PubMed

    2016-05-17

    This final rule specifies the process and timeline for expanding CMS' existing Medicare Secondary Payer (MSP) Web portal to conform to section 201 of the Medicare IVIG and Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act). The final rule specifies a timeline for developing a multifactor authentication solution to securely permit authorized users other than the beneficiary to access CMS' MSP conditional payment amounts and claims detail information via the MSP Web portal. It also requires that we add functionality to the existing MSP Web portal that permits users to: Notify us that the specified case is approaching settlement; obtain time and date stamped final conditional payment summary statements and amounts before reaching settlement; and ensure that relatedness disputes and any other discrepancies are addressed within 11 business days of receipt of dispute documentation. PMID:27192735

  13. The UK relative to other single payer-dominated healthcare markets for regenerative medicine therapies.

    PubMed

    Rose, James B; Williams, David J

    2012-05-01

    The UK has for many years been considered by businesses, including those based in the UK, as at best a second market for the launch of innovative medical technology products. Historically, this has been attributed to the slow pace of adoption in its National Health Service (NHS). The NHS is perceived to be subject to cost containment, high levels of fragmentation and a lack of strategic incentives to resolve its key failings as a market. Canada and Sweden offer examples of different operating models of healthcare delivery in a single payer-dominated market, and as a consequence, have evolved with different market characteristics. Together, these economies represent an important subsection of healthcare markets that are predominantly publically funded. This report examines the barriers to market entry for regenerative medicine products in these economies and attempts to evaluate the upcoming UK healthcare reforms in terms of impact on the regenerative medicine industry sector. PMID:22594333

  14. Phone-Delivered Brief Motivational Interventions for Mandated College Students Delivered During the Summer Months

    PubMed Central

    Borsari, Brian; Short, Erica Eaton; Mastroleo, Nadine R.; Hustad, John T.P.; Tevyaw, Tracy O’Leary; Barnett, Nancy P.; Kahler, Christopher W.; Monti, Peter M.

    2014-01-01

    Objective Across the United States, tens of thousands of college students are mandated to receive an alcohol intervention following an alcohol policy violation. Telephone interventions may be an efficient method to provide mandated students with an intervention, especially when they are away from campus during summer vacation. However, little is known about the utility of telephone-delivered brief motivational interventions. Method Participants in the study (N = 57) were college students mandated to attend an alcohol program following a campus-based alcohol citation. Participants were randomized to a brief motivational phone intervention (pBMI) (n = 36) or assessment only (n = 21). Ten participants (27.8%) randomized to the pBMI did not complete the intervention. Follow-up assessments were conducted 3, 6, and 9 months post-intervention. Results Results indicated the pBMI significantly reduced the number of alcohol-related problems compared to the assessment-only group. Participants who did not complete the pBMI appeared to be lighter drinkers at baseline and randomization, suggesting the presence of alternate influences on alcohol-related problems. Conclusion Phone BMIs may be an efficient and cost-effective method to reduce harms associated with alcohol use by heavy-drinking mandated students during the summer months. PMID:24512944

  15. Minnesota State Colleges and Universities '99 Session: Mandates and Curiosities.

    ERIC Educational Resources Information Center

    Minnesota State Colleges and Universities System, St. Paul.

    This publication highlights and explains relevant Minnesota legislative developments affecting higher education. For each bill, there is a summary provided in plain English, followed by copies of related portions of the legislation. The bills presented are: (1) Higher Education Omnibus Funding Bill (H.F. 2380); (2) Bonding Omnibus Bill (H.F.…

  16. School Administrator Assessments of Bullying and State-Mandated Testing

    ERIC Educational Resources Information Center

    Lacey, Anna; Cornell, Dewey G.

    2016-01-01

    Bully victimization is associated with lower academic performance for individual students; however, less is known about the impact of bullying on the academic performance of the school as a whole. This study examined how retrospective administrator reports of both the prevalence of teasing and bullying (PTB) and the use of evidence-based bullying…

  17. Rationale for Systematic Vocabulary Development: Antidote for State Mandates

    ERIC Educational Resources Information Center

    Manzo, Anthony V.; Manzo, Ula C.; Thomas, Matthew M.

    2006-01-01

    The authors assert that vocabulary development is one of the most important things teachers can promote for students--cognitively, culturally, socially, and in preparation for standardized tests. A broad-based review of the literature reveals solid reasons for using systematic vocabulary instruction, which is especially helpful with youngsters…

  18. Evaluating Inservice Training Programs: District Response to State Mandate.

    ERIC Educational Resources Information Center

    Barbery, Madeline

    This paper describes the development of standardized evaluation procedures for Pasco County's inservice teacher education. Since 1983, legislation requires teacher education centers in Florida to report attainment data based on measurable objectives. Using a classification system adapted from the "Rand Change Agent Study," directors and…

  19. The payers perspective on MIH-CP programs. How to make a case for funding your project.

    PubMed

    Zavadsky, Matt

    2015-07-01

    Here are some key points to consider when engaging in conversations with potential payers for EMS-based MIH-CP programs. The realignment of fiscal incentives within the healthcare system has created an environment that encourages providers and payers to work together to right-size utilization. Providers and payers are often unaware of the true value EMS agencies can bring to their patients through proactive and innovative patient navigation services. You need to tell them--or, better yet, show them. You may need to do a small demonstration project with a handful of patients to prove you can make a difference. In order to understand the new environment, you need to become well-versed in healthcare metrics, specifically as they relate to the partners to whom you'll be proposing. Be sure you know things like readmission rates and penalties, value-based purchasing penalties, HCAHPS scores, MSPB and other motivating factors you. can use to help build the business case for your audience. For many in EMS, crafting partnerships for. payment of services not related to ambulance transport is a new and scary thing. Hopefully the examples provided here from payers paying for MIH services have demonstrated that their perspective is not much different from ours. We are all trying to do the right things for our patients, improve their experience of care and reduce the cost of the healthcare system. PMID:26281458

  20. Vermont's Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care

    PubMed Central

    Jones, Craig; Finison, Karl; McGraves-Lloyd, Katharine; Tremblay, Timothy; Tanzman, Beth; Hazard, Miki; Maier, Steven; Samuelson, Jenney

    2016-01-01

    Abstract Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact of these programs on outcomes for a general population remains unclear. Vermont has pursued a statewide all-payer program wherein medical home practices are supported with additional staffing from a locally organized shared resource, the community health team. Using a 6-year, sequential, cross-sectional methodology, this study reviewed annual cost, utilization, and quality outcomes for patients attributed to 123 practices participating in the program as of December 2013 versus a comparison population from each year attributed to nonparticipating practices. Populations are grouped based on their practices' stage of participation in a calendar year (Pre-Year, Implementation Year, Scoring Year, Post-Year 1, Post-Year 2). Annual risk-adjusted total expenditures per capita at Pre-Year for the participant group and comparison group were not significantly different. The difference-in-differences change from Pre-Year to Post-Year 2 indicated that the participant group's expenditures were reduced by −$482 relative to the comparison (95% CI, −$573 to −$391; P < .001). The lower costs were driven primarily by inpatient (−$218; P < .001) and outpatient hospital expenditures (−$154; P < .001), with associated changes in inpatient and outpatient hospital utilization. Medicaid participants also had a relative increase in expenditures for dental, social, and community-based support services ($57; P < .001). Participants maintained higher rates on 9 of 11 effective and preventive care measures. These results suggest that Vermont's community-oriented medical home model is associated with improved outcomes for a general population at lower expenditures and utilization. (Population Health Management 2016;19:196–205) PMID:26348492

  1. Vermont's Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care.

    PubMed

    Jones, Craig; Finison, Karl; McGraves-Lloyd, Katharine; Tremblay, Timothy; Mohlman, Mary Kate; Tanzman, Beth; Hazard, Miki; Maier, Steven; Samuelson, Jenney

    2016-06-01

    Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact of these programs on outcomes for a general population remains unclear. Vermont has pursued a statewide all-payer program wherein medical home practices are supported with additional staffing from a locally organized shared resource, the community health team. Using a 6-year, sequential, cross-sectional methodology, this study reviewed annual cost, utilization, and quality outcomes for patients attributed to 123 practices participating in the program as of December 2013 versus a comparison population from each year attributed to nonparticipating practices. Populations are grouped based on their practices' stage of participation in a calendar year (Pre-Year, Implementation Year, Scoring Year, Post-Year 1, Post-Year 2). Annual risk-adjusted total expenditures per capita at Pre-Year for the participant group and comparison group were not significantly different. The difference-in-differences change from Pre-Year to Post-Year 2 indicated that the participant group's expenditures were reduced by -$482 relative to the comparison (95% CI, -$573 to -$391; P < .001). The lower costs were driven primarily by inpatient (-$218; P < .001) and outpatient hospital expenditures (-$154; P < .001), with associated changes in inpatient and outpatient hospital utilization. Medicaid participants also had a relative increase in expenditures for dental, social, and community-based support services ($57; P < .001). Participants maintained higher rates on 9 of 11 effective and preventive care measures. These results suggest that Vermont's community-oriented medical home model is associated with improved outcomes for a general population at lower expenditures and utilization. (Population Health Management 2016;19:196-205). PMID:26348492

  2. Muddle by Mandate: A Fictionalized Account.

    ERIC Educational Resources Information Center

    Tyson-Bernstein, Harriet

    1988-01-01

    Presents a fictionalized account illustrating the process by which willful states, misguided experts, cunning marketeers, and overworked teachers and administrators produce textbooks that are ill-written, confusing, misleading, and boring. (BJV)

  3. Mandated Community Involvement: A Question of Equity

    ERIC Educational Resources Information Center

    Schwarz, Kaylan C.

    2011-01-01

    Based on the assumption that all young people and their communities would benefit from students' active participation in community endeavours, some Canadian provinces and US states have included community involvement activities graduation requirement. Debates continue over whether students should be "forced" to volunteer. Ontario's 40-hour…

  4. Socioeconomic Effects of Chronic Obstructive Pulmonary Disease from the Public Payer's Perspective in Poland.

    PubMed

    Wziątek-Nowak, Weronika; Gierczyński, Jakub; Dąbrowiecki, Piotr; Gałązka-Sobotka, Małgorzata; Fal, Andrzej M; Gryglewicz, Jerzy; Badyda, Artur J

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of death worldwide and the total number of people affected reaches over 200 million. It is estimated that approximately 50 % of persons having COPD are not aware of it. In the EU, it is estimated that the total annual costs of COPD exceed €140 billion, and the expected increase in the number of cases and deaths due to COPD would further enhance economic and social costs of the disease. In this article we present the results of cost analysis of health care benefits associated with the treatment of COPD and with the disease-related incapacity for work. The analysis is based on the data of the National Health Fund and the Social Insurance Institutions, public payers of health benefits in Poland. The annual 2012 expenditures incurred for COPD treatment was €40 million, and the benefits associated with incapacity for work reached more than €55 million. The extent of these expenditures indicates that it is necessary to optimize the functioning system, including the allocation of resources for prevention, social awareness, and detection of COPD at early stages when treatment costs are relatively low. PMID:26801147

  5. Health reform and the constitutionality of the individual mandate.

    PubMed

    Lee, Jeffrey J; Kelly, Deena; McHugh, Matthew D

    2011-11-01

    The Patient Protection and Affordable Care Act (ACA) of 2010 is landmark legislation designed to expand access to health care for virtually all legal U.S. residents. A vital but controversial provision of the ACA requires individuals to maintain health insurance coverage or face a tax penalty-the individual mandate. We examine the constitutionality of the individual mandate by analyzing relevant court decisions. A critical issue has been defining the "activities" Congress is authorized to regulate. Some judges determined that the mandate was constitutional because the decision to go without health insurance, that is, to self-insure, is an activity with substantial economic effects within the overall scheme of the ACA. Opponents suggest that Congress overstepped its authority by regulating "inactivity," that is, compelling people to purchase insurance when they otherwise would not. The U.S. Supreme Court is set to review the issues and the final ruling will shape the effectiveness of health reform. PMID:22454219

  6. Adverse Selection and an Individual Mandate: When Theory Meets Practice*

    PubMed Central

    Hackmann, Martin B.; Kolstad, Jonathan T.; Kowalski, Amanda E.

    2014-01-01

    We develop a model of selection that incorporates a key element of recent health reforms: an individual mandate. Using data from Massachusetts, we estimate the parameters of the model. In the individual market for health insurance, we find that premiums and average costs decreased significantly in response to the individual mandate. We find an annual welfare gain of 4.1% per person or $51.1 million annually in Massachusetts as a result of the reduction in adverse selection. We also find smaller post-reform markups. PMID:25914412

  7. Payer Perspectives on PCSK9 Inhibitors: A Conversation with Stephen Gorshow, MD, and James T. Kenney, RPh, MBA.

    PubMed

    Mehr, Stanton R

    2016-02-01

    The new proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can have significant budget effects, depending on the breadth of the US Food and Drug Administration (FDA)'s approved labeling. American Health & Drug Benefits asked Stephen Gorshow, MD, Regional Medical Director, UnitedHealthcare, and James T. Kenney, RPh, MBA, Manager, Specialty and Pharmacy Contracts, Harvard Pilgrim Health Care, to participate in a teleconference to better understand how payers are approaching the management of these agents. PMID:27066194

  8. Payer Perspectives on PCSK9 Inhibitors: A Conversation with Stephen Gorshow, MD, and James T. Kenney, RPh, MBA

    PubMed Central

    Mehr, Stanton R.

    2016-01-01

    The new proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can have significant budget effects, depending on the breadth of the US Food and Drug Administration (FDA)'s approved labeling. American Health & Drug Benefits asked Stephen Gorshow, MD, Regional Medical Director, UnitedHealthcare, and James T. Kenney, RPh, MBA, Manager, Specialty and Pharmacy Contracts, Harvard Pilgrim Health Care, to participate in a teleconference to better understand how payers are approaching the management of these agents. PMID:27066194

  9. 42 CFR 137.60 - May a statutorily mandated grant be added to a funding agreement?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false May a statutorily mandated grant be added to a... Statutorily Mandated Grants § 137.60 May a statutorily mandated grant be added to a funding agreement? Yes, in accordance with section 505(b)(2) of the Act , a statutorily mandated grant may be added to the...

  10. 42 CFR 137.60 - May a statutorily mandated grant be added to a funding agreement?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a statutorily mandated grant be added to a... Statutorily Mandated Grants § 137.60 May a statutorily mandated grant be added to a funding agreement? Yes, in accordance with section 505(b)(2) of the Act , a statutorily mandated grant may be added to the...

  11. 42 CFR 137.60 - May a statutorily mandated grant be added to a funding agreement?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false May a statutorily mandated grant be added to a... Statutorily Mandated Grants § 137.60 May a statutorily mandated grant be added to a funding agreement? Yes, in accordance with section 505(b)(2) of the Act , a statutorily mandated grant may be added to the...

  12. 42 CFR 137.60 - May a statutorily mandated grant be added to a funding agreement?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false May a statutorily mandated grant be added to a... Statutorily Mandated Grants § 137.60 May a statutorily mandated grant be added to a funding agreement? Yes, in accordance with section 505(b)(2) of the Act , a statutorily mandated grant may be added to the...

  13. 42 CFR 137.60 - May a statutorily mandated grant be added to a funding agreement?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May a statutorily mandated grant be added to a... Statutorily Mandated Grants § 137.60 May a statutorily mandated grant be added to a funding agreement? Yes, in accordance with section 505(b)(2) of the Act , a statutorily mandated grant may be added to the...

  14. Targeting Scarce Resources under the Older Americans Act. Hearing before the Subcommittee on Aging of the Committee on Labor and Human Resources. United States Senate, Ninety-Eighth Congress, First Session on Examination of the Targeting of Services Needed to Maintain Economic and Social Independence of Older People as Mandated in Title III of the Older Americans Act.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    This document presents prepared statements and witness testimony from the Congressional hearing on the Older Americans Act. An opening statement by Senator Charles Grassley, subcommittee chairman, contains a brief overview of the Older Americans Act. An extensive statement on the proposed targeting of services mandated under Title III of the Older…

  15. Providers, Payers, The Community, And Patients Are All Obliged To Get Patient Activation And Engagement Ethically Right

    PubMed Central

    Danis, Marion; Solomon, Mildred

    2016-01-01

    Active and engaged patients seek the understanding, knowledge, and skills to promote their own health. Efforts to promote such patient activation and engagement are ethically justified because they are consonant with the well-established principle of respect for persons and, as the evidence shows, because they are likely to produce better outcomes for patients. Yet patient activation and engagement can also go ethically awry if, for example, nonadherent patients are abandoned or are unduly disadvantaged by punitive policies and practices, or if the conditions for successful activation and engagement are missing. In this article we discuss the ethical issues and responsibilities that pertain to patients, clinicians, health care organizations, delivery systems, insurers, payers, and communities. For example, physicians or payers could hold patients blameworthy for not following recommendations, but we suggest that a better approach would be for providers and payers to empower patients to effectively share responsibility for defining goals and achieving them. An ethical approach to patient activation and engagement should place obligations not only on patients but also on clinicians, health care organizations and delivery systems, insurers, and communities. PMID:23381534

  16. Sharing risk between payer and provider by leasing health technologies: an affordable and effective reimbursement strategy for innovative technologies?

    PubMed

    Edlin, Richard; Hall, Peter; Wallner, Klemens; McCabe, Christopher

    2014-06-01

    The challenge of implementing high-cost innovative technologies in health care systems operating under significant budgetary pressure has led to a radical shift in the health technology reimbursement landscape. New reimbursement strategies attempt to reduce the risk of making the wrong decision, that is, paying for a technology that is not good value for the health care system, while promoting the adoption of innovative technologies into clinical practice. The remaining risk, however, is not shared between the manufacturer and the health care payer at the individual purchase level; it continues to be passed from the manufacturer to the payer at the time of purchase. In this article, we propose a health technology payment strategy-technology leasing reimbursement scheme-that allows the sharing of risk between the manufacturer and the payer: the replacing of up-front payments with a stream of payments spread over the expected duration of benefit from the technology, subject to the technology delivering the claimed health benefit. Using trastuzumab (Herceptin) in early breast cancer as an exemplar technology, we show how a technology leasing reimbursement scheme not only reduces the total budgetary impact of the innovative technology but also truly shares risk between the manufacturer and the health care system, while reducing the value of further research and thus promoting the rapid adoption of innovative technologies into clinical practice. PMID:24969005

  17. 17 CFR 232.101 - Mandated electronic submissions and exceptions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... affecting § 232.101 see the List of CFR Sections Affected, which appears in the Finding Aids section of the... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Mandated electronic... COMMISSION REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Electronic Filing...

  18. 17 CFR 232.101 - Mandated electronic submissions and exceptions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...)). Editorial Note: For Federal Register citations affecting § 232.101 see the List of CFR Sections Affected... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Mandated electronic... COMMISSION REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Electronic Filing...

  19. 17 CFR 232.101 - Mandated electronic submissions and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....S.C. 78l(h)). Editorial Note: For Federal Register citations affecting § 232.101 see the List of CFR... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Mandated electronic... COMMISSION REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Electronic Filing...

  20. Keeping Children Safe: Afterschool Staff and Mandated Child Maltreatment Reporting

    ERIC Educational Resources Information Center

    Gandarilla, Maria; O'Donnell, Julie

    2014-01-01

    With 8.4 million children in the U.S. spending an average of eight hours a week in afterschool programs, afterschool providers are an important part of the network of caring adults who can help to keep children safe. In addition, afterschool staff are "mandated reporters." Whether or not the laws specifically mention afterschool staff,…

  1. Implementing Mandated Change: The School as Change Contractor.

    ERIC Educational Resources Information Center

    van der Vegt, Rein; Knip, Hans

    This paper analyzes a research project that maps implementation efforts of comprehensive and mandated change at the primary school level in The Netherlands. In examining this large-scale national reform program, the report deals with schools whose innovation efforts acquired funding from the central education department in return for their local…

  2. Legal and Judicial Problems in Mandating Equal Time for Creationism.

    ERIC Educational Resources Information Center

    Skoog, Gerald

    This paper, presented at the annual meeting of the National Association of Biology Teachers, is focused on legal and judicial problems in mandating equal time for creationism. Past events provide evidence that legislation, policies, and local resolutions that require science textbooks and curricula to include the Genesis account of creation are…

  3. Resisting Reading Mandates: How To Triumph with the Truth.

    ERIC Educational Resources Information Center

    Garan, Elaine M.

    Teachers today are in a stranglehold as a glut of mandates and standards restrict their ability to make decisions in their own classrooms. In many schools, scripted, regimented commercial programs further erode their power to view their students as individuals with unique talents and needs. Even the words they use "to teach" are no longer their…

  4. What Motivates Public Support for Legally Mandated Mental Health Treatment?

    ERIC Educational Resources Information Center

    Watson, Amy C.; Corrigan, Patrick W.; Angell, Beth

    2005-01-01

    The use of legal coercion to compel individuals to participate in mental health treatment is expanding despite a lack of empirical support for many of its forms. Policies supporting mandated treatment are made by legislators and judges, often based on perceptions of public concern. Using data from the MacArthur Mental Health Module contained in…

  5. The HHS Mandate and Religious Liberty: A Primer

    ERIC Educational Resources Information Center

    Keim, Adele Auxier

    2013-01-01

    "We are in a war," Health and Human Services Secretary Kathleen Sebelius declared to cheers at a 2011 National Abortion and Reproductive Rights Action League (NARAL) Pro-Choice America fund-raiser. Secretary Sebelius was referring in part to the uproar caused by the "HHS Mandate," her agency's rule that employer-provided…

  6. Music Educators' Expertise and Mandate: Who Decides, Based on What?

    ERIC Educational Resources Information Center

    Angelo, Elin

    2016-01-01

    Who should define music educators' expertise and mandate, and on what basis? Is this for example individual music educators, diverse collectives, employment institutions or political frameworks? How can one discuss professional quality and codes of ethic in this field, where these questions inseparably adhere to personal qualities and quality of a…

  7. A Practical Response to a Legislative Phonics Mandate.

    ERIC Educational Resources Information Center

    Fox, Barbara; Wright, Marypat

    2000-01-01

    In response to a legislative mandate to teach phonics, a rural North Carolina school district devised a plan where at-risk children received small-group instruction in phonics, reading, writing, and spelling in addition to regular reading instruction. A local university trained teacher assistants to implement the plan. Reading, writing, and…

  8. 17 CFR 232.101 - Mandated electronic submissions and exceptions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Federal Register citations affecting § 232.101 see the List of CFR Sections Affected, which appears in the... 17 Commodity and Securities Exchanges 3 2014-04-01 2014-04-01 false Mandated electronic... COMMISSION REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Electronic Filing...

  9. Mandated Competency-Based Teacher Certification and the Public Interest.

    ERIC Educational Resources Information Center

    Spaulding, Robert L.

    Responding to the current lack of an empirical basis for competency-based teacher certification, Georgia has mandated studies leading to the establishment of empirical criteria. In the Carroll County Competency-Based Teacher Certification Project, the instructional behaviors of some 60 certified teachers and the classroom behaviors of the…

  10. A Review of Open Access Self-Archiving Mandate Policies

    ERIC Educational Resources Information Center

    Xia, Jingfeng; Gilchrist, Sarah B.; Smith, Nathaniel X. P.; Kingery, Justin A.; Radecki, Jennifer R.; Wilhelm, Marcia L.; Harrison, Keith C.; Ashby, Michael L.; Mahn, Alyson J.

    2012-01-01

    This article reviews the history of open access (OA) policies and examines the current status of mandate policy implementations. It finds that hundreds of policies have been proposed and adopted at various organizational levels and many of them have shown a positive effect on the rate of repository content accumulation. However, it also detects…

  11. Relational Contexts and Aesthetics: Achieving Positive Connections with Mandated Clients

    ERIC Educational Resources Information Center

    McKaig, Ann McCullough

    2003-01-01

    This article describes a model for group art therapy using an art-based and relational-aesthetic approach. The group was developed to address the complicated issues presented when working with survivors of abuse who are court-mandated to attend counseling. The concept of "gender entrapment" (Richie, 1996) is offered to explain the survivors'…

  12. [Economical situation of public payer and financing of medical benefits during the years of 1999 - 2010].

    PubMed

    Tarhoni, Mariusz; Kuszewski, Krzysztof

    2010-01-01

    The authors of the publication analyse financial effects which are the result of applying division algorithms concerning public payer organizational units during the years of 1999 - 2010. Unpublished financial data illustrating the division of financial resources in public health insurance in Poland in the years 1999 - 2009 and accepted plan for 2010 are presented. This data has been aggregated in such a way that the system of the 17 "Kasa Chorych" introduced on the 1st of January 1999, working until the 31st of March 2003 could be compared with the introduced on the 1st of April 2003 system of Voivodship Branches of NFZ (National Health Fund). Perpetual increase of expenses for benefits and medical services financed from public resources forces the necessity of rationalizing costs and financing system of these benefits. In 10 years perspective the changing tendencies of partition in the accepted algorithms of financial leveling can be seen. The obtained results allow drawing conclusions according to the rise of the level of medical benefits financing in each voivodship. There is no way of saying unmistakably whether substantial increase in financing of health care units is proportional to increased accessibility and quality of medical benefits. The changes of diversity of financial resources flow from voivodships which give away to those which take, frequent changes inside one and the same voivodship from giving away to taking can be helpful in the evaluation of rational level of financing of e.g. hospitals and helpful in forming rules of financial"sensitivity" (optimal and possible to finance) for the insured population in question. The result of the conducted analysis shows that flow of the amount of financial resources between the NFZ Voivod Branches resulting from leveling algorithms in the whole country is bigger than the planned lowering of income from premium in NFZ for the year 2010. PMID:20499670

  13. Health Care Reform in Massachusetts: Implementation of Coverage Expansions and a Health Insurance Mandate

    PubMed Central

    Doonan, Michael T; Tull, Katharine R

    2010-01-01

    Context: Much can be learned from Massachusetts's experience implementing health insurance coverage expansions and an individual health insurance mandate. While achieving political consensus on reform is difficult, implementation can be equally or even more challenging. Methods: The data in this article are based on a case study of Massachusetts, including interviews with key stakeholders, state government, and Commonwealth Health Insurance Connector Authority officials during the first three years of the program and a detailed analysis of primary and secondary documents. Findings: Coverage expansion and an individual mandate led Massachusetts to define affordability standards, establish a minimum level of insurance coverage, adopt insurance market reforms, and institute incentives and penalties to encourage coverage. Implementation entailed trade-offs between the comprehensiveness of benefits and premium costs, the subsidy levels and affordability, and among the level of mandate penalties, public support, and coverage gains. Conclusions: National lessons from the Massachusetts experience come not only from the specific decisions made but also from the process of decision making, the need to keep stakeholders engaged, the relationship of decisions to existing programs and regulations, and the interactions among program components. PMID:20377758

  14. Cumulative Effects of Federal Education Policies on Schools and Districts. Summary Report of a Congressionally Mandated Study.

    ERIC Educational Resources Information Center

    Knapp, Michael S.; And Others

    Drawing data from 20 school districts in 8 states, this study assessed the collective impact of federal categorical programs and related civil rights mandates on 6 problem areas in local school districts. Interviews with a variety of respondents in local districts focused on the federal laws' effects on instructional services for target students,…

  15. The Dragon in School Backyards: The Influence of Mandated Testing on School Contexts and Educators' Narrative Knowing

    ERIC Educational Resources Information Center

    Craig, Cheryl J.

    2004-01-01

    Researched in the narrative inquiry tradition, this article examines the influence of state-mandated accountability testing on Eagle High School's dramatically shifting context and the embodied knowledge held and expressed by principal, Henry Richards, and the Eagle teachers. Through carefully unpacking Richards's dragon in school backyards…

  16. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    PubMed Central

    Miller, Jeffrey D; Lenhart, Gregory M; Bonafede, Machaon M; Basinski, Cindy M; Lukes, Andrea S; Troeger, Kathleen A

    2015-01-01

    Objectives Abnormal uterine bleeding (AUB) interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA) provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods A health state transition (semi-Markov) model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial) and $3,000 (Medicaid); cost savings versus hysterectomy were $6,500 (commercial) and $8,900 (Medicaid). Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities, and 82%–91% fewer versus hysterectomy. Furthermore, NovaSure-treated patients had fewer days of work absence and short-term disability. Cost-effectiveness metrics showed NovaSure treatment as economically dominant over other GEA modalities in all circumstances. With few exceptions, similar

  17. Physical therapy mandates by Medicare administrative contractors: effective or wasteful?

    PubMed

    Fehring, Thomas K; Fehring, Keith; Odum, Susan M; Halsey, David

    2013-10-01

    Documentation of medical necessity for arthroplasty has come under scrutiny by Medicare. In some jurisdictions three months of physical therapy prior to arthroplasty has been mandated. The purpose of this study was to determine the efficacy and cost of this policy to treat advanced osteoarthritis. A systematic review was performed to assimilate efficacy data for physical therapy in patients with advanced osteoarthritis. The number of arthroplasties performed annually was obtained to calculate cost. Evidence-based studies documenting the efficacy of physical therapy in treating advanced arthritis are lacking with a potential cost of 36-68 million dollars. Physical therapy mandates by administrative contractors are not only ineffective but are costly without patient benefit. Medical necessity documentation should be driven by orthopedists not retroactively by Medicare contractors. PMID:23796555

  18. Quality improvement in nursing: Administrative mandate or professional responsibility?

    PubMed Central

    Izumi, Shigeko

    2012-01-01

    For professionals, providing quality service and striving for excellence are ethical responsibilities. In many hospitals in the U.S., however, there is evidence indicating current quality improvement (QI) involving nurses is not always driven by their professional accountability and professional values. QI has become more an administrative mandate than an ethical standard for nurses. In this paper, the tension between QI as nurses’ professional ethics and an administrative mandate will be described, and the implicit ideal-reality gap of QI will be examined. The threat to professional nursing posed by the current approach to QI will be examined, and ways to incorporate nursing professional values in a practical QI effort will be explored. PMID:23127240

  19. Health Reform and the Constitutionality of the Individual Mandate

    PubMed Central

    Lee, Jeffrey J.; Kelly, Deena; McHugh, Matthew D.

    2012-01-01

    The Patient Protection and Affordable Care Act (ACA) of 2010 is landmark legislation designed to expand access to health care for virtually all legal U.S. residents. A vital but controversial provision of the ACA requires individuals to maintain health insurance coverage or face a tax penalty—the individual mandate. We examine the constitutionality of the individual mandate by analyzing relevant court decisions. A critical issue has been defining the “activities” Congress is authorized to regulate. Some judges determined that the mandate was constitutional because the decision to go without health insurance, that is, to self-insure, is an activity with substantial economic effects within the overall scheme of the ACA. Opponents suggest that Congress overstepped its authority by regulating “inactivity,” that is, compelling people to purchase insurance when they otherwise would not. The U.S. Supreme Court is set to review the issues and the final ruling will shape the effectiveness of health reform. PMID:22454219

  20. Rice fortification: a comparative analysis in mandated settings.

    PubMed

    Forsman, Carmen; Milani, Peiman; Schondebare, Jill A; Matthias, Dipika; Guyondet, Christophe

    2014-09-01

    Legal mandates can play an important role in the success of rice fortification programs that involve the private sector. However, merely enacting mandatory legislation does not guarantee success; it requires a coordinated, multidimensional cross-sector effort that addresses stewardship, develops an appropriate rice fortification technology, enables sustainable production and distribution channels through a range of private-sector players, ensures quality, generates consumer demand, and monitors progress. Furthermore, economic sustainability must be built into the supply chain and distribution network to enable the program to outlast government administrations and/or time-limited funding. Hence, mandates can serve as valuable long-term enablers of cross-sector mobilization and collaboration and as catalysts of civil society engagement in and ownership of fortification programs. This paper compares the rice fortification experiences of Costa Rica and the Philippines--two countries with mandates, yet distinctly different industry landscapes. Costa Rica has achieved national success through strong government stewardship and active market development--key elements of success regardless of industry structure. With a comparatively more diffuse rice industry structure, the Philippines has also had success in limited geographies where key stakeholders have played an active role in market development. A comparative analysis provides lessons that may be relevant to other rice fortification programs. PMID:24913356

  1. In Japan, all-payer rate setting under tight government control has proved to be an effective approach to containing costs.

    PubMed

    Ikegami, Naoki; Anderson, Gerard F

    2012-05-01

    In Japan's health insurance system, the prices paid by multiple payers for nearly all health care goods and services are codified into a single fee schedule and are individually revised within the global rate set by the government. This single payment system has allowed total health care spending to be controlled despite a fee-for-service system with its incentives for increased volume of services; Japan's growing elderly population; and the regular introduction of new technologies and therapies. This article describes aspects of Japan's approach, as well as how that nation has expanded payment for inpatient hospital care based on case-mix. The result of the payment system is that Japan's rate of health spending growth has been well below that of other industrial nations. The percentage of gross domestic product spent on health increased from 7.7 percent in 2000 to 8.5 percent in 2008, compared to an increase from 13.7 percent to 16.4 percent in the United States. Japan's approach confirms that enlightened government regulation can maintain access to care, avoid rationing, make use of the latest technology, and allow for multiple insurance plans and an aging population--all while restraining the growth of health care spending. PMID:22566445

  2. Transformative Use of an Improved All-Payer Hospital Discharge Data Infrastructure for Community-Based Participatory Research: A Sustainability Pathway

    PubMed Central

    Salemi, Jason L; Salinas-Miranda, Abraham A; Wilson, Roneé E; Salihu, Hamisu M

    2015-01-01

    Objective To describe the use of a clinically enhanced maternal and child health (MCH) database to strengthen community-engaged research activities, and to support the sustainability of data infrastructure initiatives. Data Sources/Study Setting Population-based, longitudinal database covering over 2.3 million mother–infant dyads during a 12-year period (1998–2009) in Florida. Setting: A community-based participatory research (CBPR) project in a socioeconomically disadvantaged community in central Tampa, Florida. Study Design Case study of the use of an enhanced state database for supporting CBPR activities. Principal Findings A federal data infrastructure award resulted in the creation of an MCH database in which over 92 percent of all birth certificate records for infants born between 1998 and 2009 were linked to maternal and infant hospital encounter-level data. The population-based, longitudinal database was used to supplement data collected from focus groups and community surveys with epidemiological and health care cost data on important MCH disparity issues in the target community. Data were used to facilitate a community-driven, decision-making process in which the most important priorities for intervention were identified. Conclusions Integrating statewide all-payer, hospital-based databases into CBPR can empower underserved communities with a reliable source of health data, and it can promote the sustainability of newly developed data systems. PMID:25879276

  3. Children's Medicaid enrollment: the impacts of mandates, welfare reform, and policy delinking.

    PubMed

    Kronebusch, K

    2001-12-01

    From 1984 to 1990. Congress enacted a series of mandates that expanded Medicaid eligibility for low-income children by gradually delinking Medicaid eligibility from welfare eligibility. The 1996 national welfare reform law nominally completed the delinking process when the statutory phase-in of children's Medicaid coverage was preserved even as the states were given increased flexibility for administering welfare programs. This article provides estimates of the impact of these fedcral policy changes on children's Medicaid enrollment rates and analyzes the degree of success in uncoupling children's Medicaid enrollment from welfare. Data from the Current Population Survey for 1979 to 1998 are used to provide standardized enrollment probabilities for the United States and individual states. The results show important enrollment increases associated with the period of the mandated expansions, followed by enrollment declines associated with welfare reform. The largest increases in enrollment during this period were in states with historically restrictive welfare eligibility, but rates also rose in states that previously had relatively expansive welfare eligibility. The net effect was a reduction in the extent of state-to-state variation in enrollment. The Medicaid expansion peaked in 1995, prior to the advent of national welfare reform. Since then, children's Medicaid enrollment has fallen, with the largest declines falling on families with the very lowest incomes. Consistent with the desire to delink children's Medicaid coverage from welfare, the association between Medicaid and AFDC/TANF enrollment weakened during the expansionary period, but there still was a relatively strong relationship between policy outcomes for these two programs. Despite the policy changes, Medicaid coverage of children is still influenced by state-level welfare policy. PMID:11831579

  4. Characteristics, needs, and help seeking of partner violence victims mandated to community services by courts and child protective services.

    PubMed

    Macy, Rebecca J; Rizo, Cynthia F; Ermentrout, Dania M

    2013-10-01

    The rapid growth of a subpopulation of women victimized by intimate partner violence (IPV) garnered the attention of 2 human service agencies in 1 Southeastern United States city. These agencies noted a shift in their clientele from female IPV victims who voluntarily sought agency services to victims who were mandated to agency services by child protective services (CPS), the court system, or both. Court-referred victims had been arrested for perpetrating IPV against their male partners. CPS-referred victims were experiencing concerning levels of IPV in their families, whether or not the victim had ever perpetrated IPV. Moreover, this subpopulation of women tended to be primary caregivers of children. In response to the growth of this subpopulation, the agencies collaborated to design and implement a program targeting female IPV victims who were primary caregivers for their children and who had been mandated to the agencies' services. The research team partnered with the agencies to conduct an investigation of this community-developed program and its participants. This article presents an exploratory, descriptive study that investigates (a) the characteristics of service-mandated, parenting IPV victims; (b) the needs of service-mandated, parenting IPV victims; and (c) the types of help-seeking behavior these women had engaged in before their service referral. Study findings indicate that, although the participants showed parenting strengths and active help-seeking efforts, this sample of women was characterized by severe IPV experiences and serious mental health needs. PMID:24164530

  5. The evolution of healthcare quality measurement in the United States.

    PubMed

    Burstin, H; Leatherman, S; Goldmann, D

    2016-02-01

    Quality measurement is fundamental to systematic improvement of the healthcare system. Whilst the United States has made significant investments in healthcare quality measurement and improvement, progress has been somewhat limited. Public and private payers in the United States increasingly mandate measurement and reporting as part of pay-for-performance programmes. Numerous issues have limited improvement, including lack of alignment in the use of measures and improvement strategies, the fragmentation of the U.S. healthcare system, and the lack of national electronic systems for measurement, reporting, benchmarking and improvement. Here, we provide an overview of the evolution of U.S. quality measurement efforts, including the role of the National Quality Forum. Important contextual changes such as the growing shift towards electronic data sources and clinical registries are discussed together with international comparisons. In future, the U.S. healthcare system needs to focus greater attention on the development and use of measures that matter. The three-part aim of effective care, affordable care and healthy communities in the U.S. National Quality Strategy focuses attention on population health and reduction in healthcare disparities. To make significant improvements in U.S. health care, a closer connection between measurement and both evolving national data systems and evidence-based improvement strategies is needed. PMID:26785953

  6. How would business react to an employer mandate?

    PubMed

    McArdle, F B

    As difficult and controversial as it is to pass an employer mandate, implementation will be even harder. Business reactions will not be monolithic, but diverse and complicated, often diametrically opposed. Reactions also will vary dramatically with the actual design of the provision in question, for which there are many alternatives. "What exists out there now" has overt and subtle variations from employer to employer, from region to region, and from sector to sector. If an employer obligation were designed to be more respectful and reflective of that diversity, the odds of gaining greater acceptance and successful implementation by business would improve. PMID:8056392

  7. The impact of maternity length-of-stay mandates on the labor market and insurance coverage.

    PubMed

    Sabik, Lindsay M; Laugesen, Miriam J

    2012-01-01

    To understand the effects of insurance regulation on the labor market and insurance coverage, this study uses a difference-in-difference-in-differences analysis to compare five states that passed minimum maternity length-of-stay laws with states that waited until after a federal law was passed. On average, we do not find statistically significant effects on labor market outcomes such as hours of work and wages. However, we find that employees of small firms in states with maternity length-of-stay mandates experienced a 6.2-percentage-point decline in the likelihood of having employer-sponsored insurance. Implementation of federal health reform that requires minimum benefit standards should consider the implications for firms of differing sizes. PMID:22650016

  8. Mandate-based health reform and the labor market: Evidence from the Massachusetts reform.

    PubMed

    Kolstad, Jonathan T; Kowalski, Amanda E

    2016-05-01

    We model the labor market impact of the key provisions of the national and Massachusetts "mandate-based" health reforms: individual mandates, employer mandates, and subsidies. We characterize the compensating differential for employer-sponsored health insurance (ESHI) and the welfare impact of reform in terms of "sufficient statistics." We compare welfare under mandate-based reform to welfare in a counterfactual world where individuals do not value ESHI. Relying on the Massachusetts reform, we find that jobs with ESHI pay $2812 less annually, somewhat less than the cost of ESHI to employers. Accordingly, the deadweight loss of mandate-based health reform was approximately 8 percent of its potential size. PMID:27037897

  9. Nudges or mandates? The ethics of mandatory flu vaccination.

    PubMed

    Dubov, Alex; Phung, Connie

    2015-05-21

    According to the CDC report for the 2012-2013 influenza season, there was a modest increase in the vaccination coverage rate among healthcare workers from 67% in 2011-2012, to 72% in 2012-2013 to the current 75% coverage. This is still far from reaching the US National Healthy People 2020 goal of 90% hospitals vaccination rates. The reported increase in coverage is attributed to the growing number of healthcare facilities with vaccination requirements with average rates of 96.5%. However, a few other public health interventions stir so much controversy and debate as vaccination mandates. The opposition stems from the belief that a mandatory flu shot policy violates an individual right to refuse unwanted treatment. This article outlines the historic push to achieve higher vaccination rates among healthcare professionals and a number of ethical issues arising from attempts to implement vaccination mandates. It then turns to a review of cognitive biases relevant in the context of decisions about influenza vaccination (omission bias, ambiguity aversion, present bias etc.) The article suggests that a successful strategy for policy-makers and others hoping to increase vaccination rates is to design a "choice architecture" that influences behavior of healthcare professionals without foreclosing other options. Nudges incentivize vaccinations and help better align vaccination intentions with near-term actions. PMID:25869886

  10. Access to and use of infertility services in the United States: framing the challenges.

    PubMed

    Adashi, Eli Y; Dean, Laura A

    2016-05-01

    An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States (U.S.) shows a declining trend for the ever-use of infertility services. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the U.S. can only be characterized as dismal. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the state of underwriting of general infertility and ART services in the U.S. must be embraced as a central moral imperative and as an unwavering strategic goal of the professional societies entrusted with the reproductive health of women and men. PMID:26826275

  11. Beyond capitation: how new payment experiments seek to find the 'sweet spot' in amount of risk providers and payers bear.

    PubMed

    Frakt, Austin B; Mayes, Rick

    2012-09-01

    A key issue in the decades-long struggle over US health care spending is how to distribute liability for expenses across all market participants, from insurers to providers. The rise and abandonment in the 1990s of capitation payments-lump-sum, per person payments to health care providers to provide all care for a specified individual or group-offers a stark example of how difficult it is for providers to assume meaningful financial responsibility for patient care. This article chronicles the expansion and decline of the capitation model in the 1990s. We offer lessons learned and assess the extent to which these lessons have been applied in the development of contemporary forms of provider cost sharing, particularly accountable care organizations, which in effect constitute a search for the "sweet spot," or appropriate place on a spectrum, between providers and payers with respect to the degree of risk they absorb. PMID:22949443

  12. Intrinsicality: reconsidering spirituality, meaning(s) and mandates.

    PubMed

    Hammell, K W

    2001-06-01

    Canadian occupational therapists have placed spirituality as the central core of their theoretical Model, depicting inner and outer selves that contradict simultaneous declarations concerning the integration of mind/body/spirit. Even the word spirituality has discrepant meanings and failure to articulate one chosen meaning leads to ambiguity. This paper argues that occupational therapists must agree upon a single definition of spirituality that is congruent with our professional mandate and philosophical perspective; and that prevention of misunderstandings between and amongst clients and other health care professionals demands recourse to our own terminology. It is proposed that intrinsicality be employed to articulate the personal philosophy of meaning with which we interpret our lives. Influenced by environmental context and in homeostatic relationship with the body and mind, intrinsicality constitutes the essence of the self and informs occupational choices based upon personal values and priorities. Acknowledgement of intrinsicality respects the uniqueness of individuals' meanings. PMID:11433917

  13. Why Hospitals and Payers are Recommending Home Care Upon Discharge Instead of SNF or Traditional Home Health Services--Alternative Payment Model Hospital Incentives Aligning with Patient Choice.

    PubMed

    Luke, Josh

    2016-01-01

    Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely non-medical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model. PMID:27180473

  14. B2, B7 or B10: Which palm-based blend mandate wise to be chosen in Malaysia?

    SciTech Connect

    Applanaidu, Shri-Dewi Ali, Anizah Md.; Abidin, Norhaslinda Zainal

    2015-12-11

    The diminishing fossil energy resources, coupled with heightened interest in the abatement of greenhouse gas emissions and concerns about energy security have motivated Malaysia to produce palm-based biodiesel and it has been started to be exported since 2006. In line with this issue, the government in Malaysia launched the palm-based biodiesel blending mandate of five percent (B5) in the federal administration of Putrajaya on 1{sup st} June 2011. This was then followed by four states: Malacca on July 11, Negeri Sembilan on August 1, Kuala Lumpur on September 1 and Selangor on October 1 of the same year but it is yet to be implemented nationwide. However what is the wise blend mandate to be chosen? Thus, this paper seeks to examine the possible impact of various blend mandates implementation (B2, B7 and B10) on the palm oil industry market variables (stock and price) since the main aim of biodiesel industry in Malaysia is to reduce domestic palm oil stock to below one million tones and provide a floor price to support Crude Palm Oil (CPO) prices at RM2,000 per tonne. A structural econometric model consisting of nine structural equations and three identities was proposed in this study. The model has been estimated by two stage least squares (2SLS) method using annual data for the period 1976-2013. The study indicates that counterfactual simulation of a decrease from B5 to B2 predicts a decrease (11.2 per cent) in CPO domestic consumption for biodiesel usage, 731.02 per cent reduction in CPO stock and an increase of 27.41 percent in domestic price of CPO. However the increase in the blend mandate from B5 to B7 and B10 suggest that domestic consumption of CPO for biodiesel purpose increase 7.40 and 18.55 percent respectively. The interesting findings in this study suggest that no matter whether Malaysian government increase or decrease the blend mandate the increase in the price of CPO are the same with an increase of is 27.41 percent. Hence, this study suggests that

  15. B2, B7 or B10: Which palm-based blend mandate wise to be chosen in Malaysia?

    NASA Astrophysics Data System (ADS)

    Applanaidu, Shri-Dewi; Abidin, Norhaslinda Zainal; Ali, Anizah Md.

    2015-12-01

    The diminishing fossil energy resources, coupled with heightened interest in the abatement of greenhouse gas emissions and concerns about energy security have motivated Malaysia to produce palm-based biodiesel and it has been started to be exported since 2006. In line with this issue, the government in Malaysia launched the palm-based biodiesel blending mandate of five percent (B5) in the federal administration of Putrajaya on 1st June 2011. This was then followed by four states: Malacca on July 11, Negeri Sembilan on August 1, Kuala Lumpur on September 1 and Selangor on October 1 of the same year but it is yet to be implemented nationwide. However what is the wise blend mandate to be chosen? Thus, this paper seeks to examine the possible impact of various blend mandates implementation (B2, B7 and B10) on the palm oil industry market variables (stock and price) since the main aim of biodiesel industry in Malaysia is to reduce domestic palm oil stock to below one million tones and provide a floor price to support Crude Palm Oil (CPO) prices at RM2,000 per tonne. A structural econometric model consisting of nine structural equations and three identities was proposed in this study. The model has been estimated by two stage least squares (2SLS) method using annual data for the period 1976-2013. The study indicates that counterfactual simulation of a decrease from B5 to B2 predicts a decrease (11.2 per cent) in CPO domestic consumption for biodiesel usage, 731.02 per cent reduction in CPO stock and an increase of 27.41 percent in domestic price of CPO. However the increase in the blend mandate from B5 to B7 and B10 suggest that domestic consumption of CPO for biodiesel purpose increase 7.40 and 18.55 percent respectively. The interesting findings in this study suggest that no matter whether Malaysian government increase or decrease the blend mandate the increase in the price of CPO are the same with an increase of is 27.41 percent. Hence, this study suggests that the

  16. Heterogeneity and the Effect of Mental Health Parity Mandates on the Labor Market*

    PubMed Central

    Andersen, Martin

    2015-01-01

    Health insurance benefit mandates are believed to have adverse effects on the labor market, but efforts to document such effects for mental health parity mandates have had limited success. I show that one reason for this failure is that the association between parity mandates and labor market outcomes vary with mental distress. Accounting for this heterogeneity, I find adverse labor market effects for non-distressed individuals, but favorable effects for moderately distressed individuals and individuals with a moderately distressed family member. On net, I conclude that the mandates are welfare increasing for moderately distressed workers and their families, but may be welfare decreasing for non-distressed individuals. PMID:26210944

  17. Assessing clarity of message communication for mandated USEPA drinking water quality reports.

    PubMed

    Phetxumphou, Katherine; Roy, Siddhartha; Davy, Brenda M; Estabrooks, Paul A; You, Wen; Dietrich, Andrea M

    2016-04-01

    The United States Environmental Protection Agency mandates that community water systems (CWSs), or drinking water utilities, provide annual consumer confidence reports (CCRs) reporting on water quality, compliance with regulations, source water, and consumer education. While certain report formats are prescribed, there are no criteria ensuring that consumers understand messages in these reports. To assess clarity of message, trained raters evaluated a national sample of 30 CCRs using the Centers for Disease Control Clear Communication Index (Index) indices: (1) Main Message/Call to Action; (2) Language; (3) Information Design; (4) State of the Science; (5) Behavioral Recommendations; (6) Numbers; and (7) Risk. Communication materials are considered qualifying if they achieve a 90% Index score. Overall mean score across CCRs was 50 ± 14% and none scored 90% or higher. CCRs did not differ significantly by water system size. State of the Science (3 ± 15%) and Behavioral Recommendations (77 ± 36%) indices were the lowest and highest, respectively. Only 63% of CCRs explicitly stated if the water was safe to drink according to federal and state standards and regulations. None of the CCRs had passing Index scores, signaling that CWSs are not effectively communicating with their consumers; thus, the Index can serve as an evaluation tool for CCR effectiveness and a guide to improve water quality communications. PMID:27105408

  18. Measuring Hospital Quality: Can Medicare Data Substitute for All-Payer Data?

    PubMed Central

    Needleman, Jack; Buerhaus, Peter I; Mattke, Soeren; Stewart, Maureen; Zelevinsky, Katya

    2003-01-01

    Objectives To assess whether adverse outcomes in Medicare patients can be used as a surrogate for measures from all patients in quality-of-care research using administrative datasets. Data Sources Patient discharge abstracts from state data systems for 799 hospitals in 11 states. National MedPAR discharge data for Medicare patients from 3,357 hospitals. State hospital staffing surveys or financial reports. American Hospital Association Annual Survey. Study Design We calculate rates for 10 adverse patient outcomes, examine the correlation between all-patient and Medicare rates, and conduct negative binomial regressions of counts of adverse outcomes on expected counts, hospital nurse staffing, and other variables to compare results using all-patient and Medicare patient data. Data Collection/Extraction Coding rules were established for eight adverse outcomes applicable to medical and surgical patients plus two outcomes applicable only to surgical patients. The presence of these outcomes was coded for 3 samples: all patients in the 11-state sample, Medicare patients in the 11-state sample, and Medicare patients in the national Medicare MedPAR sample. Logistic regression models were used to construct estimates of expected counts of the outcomes for each hospital. Variables for teaching, metropolitan status, and bed size were obtained from the AHA Annual Survey. Principal Findings For medical patients, Medicare rates were consistently higher than all-patient rates, but the two were highly correlated. Results from regression analysis were consistent across the 11-state all-patient, 11-state Medicare, and national Medicare samples. For surgery patients, Medicare rates were generally higher than all-patient rates, but correlations of Medicare and all-patient rates were lower, and regression results less consistent. Conclusions Analyses of quality of care for medical patients using Medicare-only and all-patient data are likely to have similar findings. Measures applied to

  19. Open access mandate threatens dissemination of scientific information.

    PubMed

    McMullan, Erin

    2008-03-01

    The public good is served when researchers can most easily access current, high-quality research through articles that have undergone rigorous peer review and quality control processes. The free market has allowed researchers excellent access to quality research articles through the investment of societies and commercial publishers in these processes for publication of scholarly journals in a wide variety of specialty and subspecialty areas. Government legislation mandating "open access" to copyrighted articles through a government Web site could result in a reduction of financially sustainable peer-reviewed journals and a reduction in the overall quality of articles available as publishers, societies, and authors are forced to hand over their intellectual property or restrict the peer review process because of lost sales opportunities. The public is best served when the work of researchers advances science to its benefit. If researchers have fewer current resources, diminished quality control, or access to fewer trusted peer-reviewed journals, the public could ultimately lose more than it could gain from open access legislation. PMID:18347464

  20. Telemental health: responding to mandates for reform in primary healthcare.

    PubMed

    Myers, Kathleen M; Lieberman, Daniel

    2013-06-01

    Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care. PMID:23611641

  1. Mandated empowerment: handing antipoverty policy back to the poor?

    PubMed

    Banerjee, Abhijit V; Duflo, Esther

    2008-01-01

    The current trend in antipoverty policy emphasizes mandated empowerment: the poor are being handed the responsibility for making things better for themselves, largely without being asked whether this is what they want. Beneficiary control is now being built into public service delivery, while microcredit and small business promotion are seen as better ways to help the poor. The clear presumption is that the poor are both able and happy to exercise these new powers. This essay uses two examples to raise questions about these strategies. The first example is about entrepreneurship among the poor. Using data from a number of countries, we argue that there is no evidence that the median poor entrepreneur is trying his best to expand his existing businesses, even if we take into account the many constraints he faces. While many poor people own businesses, this seems to be more a survival strategy than something they want to do. The second example comes from an evaluation of a program in India that aims to involve poor rural parents in improving local public schools. The data suggest that despite being informed that they now have both the right to intervene in the school and access to funds for that purpose, and despite being made aware of how little the children were learning, parents opt to not get involved. Both examples raise concerns about committing ourselves entirely to antipoverty strategies that rely on the poor doing a lot of the work. PMID:18579890

  2. Alcohol Use Problems Mediate the Relation between Cannabis Use Frequency and College Functioning among Students Mandated to an Alcohol Diversion Program

    ERIC Educational Resources Information Center

    McChargue, Dennis E.; Klanecky, Alicia K.; Anderson, Jennifer

    2012-01-01

    The present study examined the degree to which alcohol use problems explained the relationship between cannabis use frequency and college functioning. Undergraduates (N = 546) mandated to an alcohol diversion program at a Midwestern United States university completed screening questionnaires between October 2003 and April 2006. Sobel's (1982) test…

  3. 38 CFR 17.106 - VA collection rules; third-party payers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Social Security Act (42 U.S.C. 1395, et seq.) and 42 CFR part 403, subpart B. No-fault insurance means an... calculated using the applicable method for such charges established by VA in 38 CFR 17.101. (2) If the third... United States under 31 U.S.C. 3701, et seq., 4 CFR parts 101 through 104, 28 CFR part 11, 31 CFR part...

  4. An Investment Model Analysis of Relationship Stability among Women Court-Mandated to Violence Interventions

    ERIC Educational Resources Information Center

    Rhatigan, Deborah L.; Moore, Todd M.; Stuart, Gregory L.

    2005-01-01

    This investigation examined relationship stability among 60 women court-mandated to violence interventions by applying a general model (i.e., Rusbult's 1980 Investment Model) to predict intentions to leave current relationships. As in past research, results showed that Investment Model predictions were supported such that court-mandated women who…

  5. The Impact of Single-Payer Health Care on Physician Income in Canada, 1850–2005

    PubMed Central

    2011-01-01

    This study traces the average net income of Canadian physicians over 150 years to determine the impact of medicare. It also compares medical income in Canada to that in the United States. Sources include academic studies, government reports, Census data, taxation statistics, and surveys. The results show that Canadian doctors enjoyed a windfall in earnings during the early years of medicare and that, after a period of adjustment, medicare enhanced physician income. Except during the windfall boom, Canadian physicians have earned less than their American counterparts. Until at least 2005, however, the medical profession was the top-earning trade in Canada relative to all other professions. PMID:21566029

  6. Medical image security in a HIPAA mandated PACS environment.

    PubMed

    Cao, F; Huang, H K; Zhou, X Q

    2003-01-01

    Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information. PMID:12620309

  7. Melding regulatory, pharmaceutical industry, and U.S. payer perspectives on improving approaches to heterogeneity of treatment effect in research and practice.

    PubMed

    Willke, Richard J; Crown, William; Del Aguila, Michael; Cziraky, Mark J; Khan, Zeba M; Migliori, Richard

    2013-01-01

    Effective pursuit of the science and management of heterogeneity of treatment effect (HTE) relies on the mutual understanding of the perspectives of, and collaboration among, the various stakeholders in health care. In this article, we compare, contrast, and endeavor to find areas of alignment across the perspectives of three such stakeholders -regulators, the biopharmaceutical and device industry, and U.S. payers. First, we discuss how evidence of HTE is generated and could be improved upon. For pharmaceuticals, much of the initial research is conducted by the pharmaceutical industry, guided by basic science but also delimited by potential markets, regulatory approval requirements, trial size considerations, and payer expectations for evidence of value. Once a drug is marketed, further evidence can be generated via combining trial data, conducting meta-analysis, and analyzing real-world results through observational research designs; we explore how these efforts can benefit from cooperation across these stakeholders. Second, we discuss the equally important utilization of HTE evidence so that physicians and patients have access to and can benefit from the learnings from this research. Research findings must be translated into actionable information and guidelines that can be incorporated into everyday practice. Doing so requires interaction and collaboration among all involved, based on facilitated communication as well as further evaluation research. We provide examples of several cross-sectorial initiatives that are under way in this area. Finally, we explore some economic aspects of HTE research as part of the drug development, marketing, and treatment process. Understanding the economic incentives present is fundamental to aligning those incentives to improve the availability and utilization of HTE evidence. Clear understandings among regulators, pharma, and payers about high-value targets, methods to efficiently generate and communicate information, and value

  8. Exposure of California Kindergartners to Students With Personal Belief Exemptions From Mandated School Entry Vaccinations

    PubMed Central

    Jones, Malia; Baras, Yelena

    2012-01-01

    Objectives. Personal belief exemptions (PBEs) from mandated school entry vaccinations have increased in California over the past decade. Infectious disease outbreaks in the state may be associated with the aggregation of intentionally unvaccinated children within schools. We sought to quantify the exposure of California kindergartners to children with PBEs at school. Methods. We used cross-sectional California Department of Public Health data on 3 kindergarten cohorts to define and calculate multiple measures of exposure to children with exemptions, including interaction and aggregation indices, for the state as a whole (2008–2010) and by county (2010). Results. In 2010, the PBE rate in California was 2.3 per 100 students, and the school PBE rate for the average kindergartner with a PBE was 15.6 per 100. More than 7000 kindergartners in California attend schools with PBE rates greater than 20 per 100, including 2700 kindergartners with PBEs. Exposure measures vary considerably across counties. Conclusions. Our results suggest increasing levels of exposure among kindergarten students in California to other kindergartners with PBEs. Our data provide a concrete set of metrics through which public health and education officials can identify high-risk areas as targets for policy and programmatic interventions. PMID:22698009

  9. 42 CFR 137.72 - Are Self-Governance Tribes and their employees carrying out statutorily mandated grant programs...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... published at 25 CFR Part 900, Subpart M. ... carrying out statutorily mandated grant programs added to a funding agreement covered by the Federal Tort... mandated grant programs added to a funding agreement covered by the Federal Tort Claims Act (FTCA)?...

  10. 42 CFR 137.72 - Are Self-Governance Tribes and their employees carrying out statutorily mandated grant programs...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... published at 25 CFR Part 900, Subpart M. ... carrying out statutorily mandated grant programs added to a funding agreement covered by the Federal Tort... mandated grant programs added to a funding agreement covered by the Federal Tort Claims Act (FTCA)?...

  11. 42 CFR 137.72 - Are Self-Governance Tribes and their employees carrying out statutorily mandated grant programs...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... published at 25 CFR Part 900, Subpart M. ... carrying out statutorily mandated grant programs added to a funding agreement covered by the Federal Tort... mandated grant programs added to a funding agreement covered by the Federal Tort Claims Act (FTCA)?...

  12. 42 CFR 137.72 - Are Self-Governance Tribes and their employees carrying out statutorily mandated grant programs...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... published at 25 CFR Part 900, Subpart M. ... carrying out statutorily mandated grant programs added to a funding agreement covered by the Federal Tort... mandated grant programs added to a funding agreement covered by the Federal Tort Claims Act (FTCA)?...

  13. 42 CFR 137.72 - Are Self-Governance Tribes and their employees carrying out statutorily mandated grant programs...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... published at 25 CFR Part 900, Subpart M. ... carrying out statutorily mandated grant programs added to a funding agreement covered by the Federal Tort... mandated grant programs added to a funding agreement covered by the Federal Tort Claims Act (FTCA)?...

  14. 42 CFR 137.69 - May a statutorily mandated grant program added to a funding agreement be redesigned?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a statutorily mandated grant program added to a funding agreement be redesigned? 137.69 Section 137.69 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF...-GOVERNANCE Statutorily Mandated Grants § 137.69 May a statutorily mandated grant program added to a...

  15. 42 CFR 137.70 - Are the reporting requirements different for a statutorily mandated grant program added to a...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... statutorily mandated grant program added to a funding agreement? 137.70 Section 137.70 Public Health PUBLIC... requirements different for a statutorily mandated grant program added to a funding agreement? Yes, the reporting requirements for a statutorily mandated grant program added to a funding agreement are subject...

  16. 42 CFR 137.69 - May a statutorily mandated grant program added to a funding agreement be redesigned?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false May a statutorily mandated grant program added to a...-GOVERNANCE Statutorily Mandated Grants § 137.69 May a statutorily mandated grant program added to a funding... terms and conditions of the grant award, a program added to a funding agreement under a...

  17. 42 CFR 137.70 - Are the reporting requirements different for a statutorily mandated grant program added to a...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... statutorily mandated grant program added to a funding agreement? 137.70 Section 137.70 Public Health PUBLIC... requirements different for a statutorily mandated grant program added to a funding agreement? Yes, the reporting requirements for a statutorily mandated grant program added to a funding agreement are subject...

  18. 42 CFR 137.68 - May funds from a statutorily mandated grant added to a funding agreement be reallocated?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false May funds from a statutorily mandated grant added to a funding agreement be reallocated? 137.68 Section 137.68 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.68 May funds from a statutorily mandated grant...

  19. 42 CFR 137.69 - May a statutorily mandated grant program added to a funding agreement be redesigned?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May a statutorily mandated grant program added to a...-GOVERNANCE Statutorily Mandated Grants § 137.69 May a statutorily mandated grant program added to a funding... terms and conditions of the grant award, a program added to a funding agreement under a...

  20. 42 CFR 137.68 - May funds from a statutorily mandated grant added to a funding agreement be reallocated?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May funds from a statutorily mandated grant added to a funding agreement be reallocated? 137.68 Section 137.68 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.68 May funds from a statutorily mandated grant...

  1. 42 CFR 137.68 - May funds from a statutorily mandated grant added to a funding agreement be reallocated?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May funds from a statutorily mandated grant added to a funding agreement be reallocated? 137.68 Section 137.68 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.68 May funds from a statutorily mandated grant...

  2. 42 CFR 137.70 - Are the reporting requirements different for a statutorily mandated grant program added to a...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... statutorily mandated grant program added to a funding agreement? 137.70 Section 137.70 Public Health PUBLIC... requirements different for a statutorily mandated grant program added to a funding agreement? Yes, the reporting requirements for a statutorily mandated grant program added to a funding agreement are subject...

  3. 42 CFR 137.68 - May funds from a statutorily mandated grant added to a funding agreement be reallocated?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false May funds from a statutorily mandated grant added to a funding agreement be reallocated? 137.68 Section 137.68 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.68 May funds from a statutorily mandated grant...

  4. 42 CFR 137.69 - May a statutorily mandated grant program added to a funding agreement be redesigned?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false May a statutorily mandated grant program added to a...-GOVERNANCE Statutorily Mandated Grants § 137.69 May a statutorily mandated grant program added to a funding... terms and conditions of the grant award, a program added to a funding agreement under a...

  5. 42 CFR 137.68 - May funds from a statutorily mandated grant added to a funding agreement be reallocated?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false May funds from a statutorily mandated grant added to a funding agreement be reallocated? 137.68 Section 137.68 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.68 May funds from a statutorily mandated grant...

  6. 42 CFR 137.70 - Are the reporting requirements different for a statutorily mandated grant program added to a...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... statutorily mandated grant program added to a funding agreement? 137.70 Section 137.70 Public Health PUBLIC... requirements different for a statutorily mandated grant program added to a funding agreement? Yes, the reporting requirements for a statutorily mandated grant program added to a funding agreement are subject...

  7. 42 CFR 137.70 - Are the reporting requirements different for a statutorily mandated grant program added to a...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... statutorily mandated grant program added to a funding agreement? 137.70 Section 137.70 Public Health PUBLIC... requirements different for a statutorily mandated grant program added to a funding agreement? Yes, the reporting requirements for a statutorily mandated grant program added to a funding agreement are subject...

  8. 42 CFR 137.69 - May a statutorily mandated grant program added to a funding agreement be redesigned?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false May a statutorily mandated grant program added to a...-GOVERNANCE Statutorily Mandated Grants § 137.69 May a statutorily mandated grant program added to a funding... terms and conditions of the grant award, a program added to a funding agreement under a...

  9. Suicide and organ donors: spillover effects of mental health insurance mandates.

    PubMed

    Fernandez, Jose; Lang, Matthew

    2015-04-01

    This paper considers the effect of mental health insurance mandates on the supply of cadaveric donors. We find that enacting a mental health mandate decreases the count of organ donors from suicides and results are driven by female donors. Using a number of empirical specifications, we calculate that the mental health parity laws are responsible for an approximately 0.52% decrease in cadaveric donors. Additional regression results show that the mandates are not related to other types of organ donations, ruling out the possibility that the mandates are related to an overall trend in the supply of organ donations. The findings suggest that future policies aimed at reducing suicide in a large and significant way can potentially increase the inefficiency that currently exists in the organ donor market. PMID:24523052

  10. Care, control, or both? Characterizing major dimensions of the mandated treatment relationship.

    PubMed

    Manchak, Sarah M; Skeem, Jennifer L; Rook, Karen S

    2014-02-01

    Current conceptualizations of the therapeutic alliance may not capture key features of therapeutic relationships in mandated treatment, which may extend beyond care (i.e., bond and affiliation) to include control (i.e., behavioral monitoring and influence). This study is designed to determine whether mandated treatment relationships involve greater control than traditional treatment relationships, and if so, whether this control covaries with reduced affiliation. In this study, 125 mental health court participants described the nature of their mandated treatment relationships using the INTREX (Benjamin, L., 2000, SASB/INTREX: Instructions for administering questionnaires, interpreting reports, and giving raters feedback (Unpublished manual). Salt Lake City, UT: University of Utah, Department of Psychology), a measure based on the interpersonal circumplex theory and assesses eight interpersonal clusters organized by orthogonal axes of affiliation and control. INTREX cluster scores were statistically compared to existing data from three separate voluntary treatment samples, and structural summary analyses were applied to distill the predominant theme of mandated treatment relationships. Compared with voluntary treatment relationships, mandated treatment relationships demonstrate greater therapist control and corresponding client submission. Nonetheless, the predominant theme of these relationships is affiliative and autonomy-granting. Although mandated treatment relationships involve significantly greater therapist control than traditional relationships, they remain largely affiliative and consistent with the principles of healthy adult attachment. PMID:23834388

  11. Does Mandated Treatment Benefit Youth? A Prospective Investigation of Adolescent Justice System Involvement, Treatment Motivation, and Substance Use Outcomes

    PubMed Central

    Yeterian, Julie D.; Greene, M. Claire; Bergman, Brandon G.; Kelly, John F.

    2013-01-01

    Background The majority of adolescents treated for substance use disorder (SUD) in the United States are now referred by the criminal justice system. Little is known, however, regarding how justice-system involvement relates to adolescent community treatment outcomes. Controversy exists, also, over the extent to which justice system involvement reflects a lack of intrinsic motivation for treatment. This study examined the relation between justice system referral and reported reason for treatment entry and tested the extent to which each predicted treatment response and outcome. Method Adolescent outpatients (N = 127; M age = 16.7, 24% female) with varying levels of justice-system involvement (i.e., no justice system involvement [No-JSI; n = 63], justice-system involved [JSI; n = 40], justice system involved-mandated [JSI-M; n = 24]) and motivation levels (i.e., self-motivated [n = 40], externally-motivated [n = 87]) were compared at treatment intake. Multilevel mixed models tested these groups’ effects on percent days abstinent (PDA) and odds of heavy drinking (HD) over 12 months. Results JSI-M were less likely to be self-motivated compared to No-JSI or JSI (p = 0.009). JSI-M had higher PDA overall, but with significant declines over time, relative to no-JSI. Self-motivated patients did not differ from externally-motivated patients on PDA or HD. Conclusions Mandated adolescent outpatients were substantially less likely to report self-motivated treatment entry. Despite the notion that self-motivated treatment entry would be likely to produce better outcomes, a judicial mandate appears to predict an initially stronger treatment response, although this diminishes over time. Ongoing monitoring and/or treatment may be necessary to help maintain treatment gains for justice system-involved adolescents. PMID:24159252

  12. Understanding modern energy policy: An evaluation of RPS mandates and behavioral nudges

    NASA Astrophysics Data System (ADS)

    Brannan, Deborah Lynn Baker

    Climate change has emerged as one of the leading policy issues of the early 21st century. In response, a variety of policies and programs have been adopted encouraging renewable energy, energy efficiency and energy conservation. My dissertation consists of three research papers which evaluate two classes of modern energy policy in the United States: renewable energy mandates and behavioral nudges. The Renewable Portfolio Standard (RPS) is the most prominent state-level renewable energy policy in the United States and has been debated several times at the federal level. Using a fixed-effects panel data model I study the existing experience of the RPS to help inform the policy debate. In contrast with the previous literature that has predominantly studied the average effect of the RPS on renewable capacity investments I explore factors resulting in the heterogeneous effect of the RPS policy. Relying on a basic understanding the electric utility industry and the electricity dispatch process I provide insight into existing experience with the RPS. Spurred by political and economic barriers to adopting renewable energy policy, interest has increased in using motivational techniques informed by behavioral science to encourage reductions in energy consumption. Existing research has predominantly addressed residential energy consumption. The remainder of my dissertation applies well-established motivational techniques to the transportation sector. Using an experimental design, I test whether real-time feedback and social norms can encourage fuel efficient driving behavior. I find that real-time feedback has a large impact on fuel economy, particularly when aggregated across the entire vehicle fleet. I also find some evidence suggesting that social norms can encourage eco-driving, but perhaps more importantly, identify key challenges associated with using social norms in a transportation setting.

  13. Preserving Today's Records for Tomorrow's Use: A Mandate for Action.

    ERIC Educational Resources Information Center

    Oklahoma Historical Records Advisory Board, Oklahoma City.

    This report presents the findings of a year-long investigation of historical records conditions and needs conducted by the Oklahoma Historical Advisory Board (OHRAB), a 12-member board appointed by the Governor to provide leadership and planning for the protection and use of the state's documentary heritage. Viewing the Oklahoma project as one…

  14. Collaboration a Make-or-Break Mandate for NCLB Waivers

    ERIC Educational Resources Information Center

    McNeil, Michele

    2011-01-01

    States that want newly offered relief from certain provisions of the No Child Left Behind Act are scrambling to satisfy an easily overlooked requirement that they "meaningfully" engage with teachers, unions, parents, and community organizations, and even modify their waiver proposals based on that input. Federal education officials warn that…

  15. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was not... operate on alternative fuels within four months after the vehicle is acquired for a State fleet; and...

  16. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was not... operate on alternative fuels within four months after the vehicle is acquired for a State fleet; and...

  17. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was not... operate on alternative fuels within four months after the vehicle is acquired for a State fleet; and...

  18. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was not... operate on alternative fuels within four months after the vehicle is acquired for a State fleet; and...

  19. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....202 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Mandatory... (regardless of the model year of manufacture), capable of operating on alternative fuels that was not... operate on alternative fuels within four months after the vehicle is acquired for a State fleet; and...

  20. Meeting the Home Language Mandate: Practical Strategies for All Classrooms

    ERIC Educational Resources Information Center

    Nemeth, Karen

    2009-01-01

    Experts throughout the United States tell us that teachers must support the home language development of all young children. Karen Nemeth emphasizes the important role early childhood educators play in ensuring that young dual language learners retain skills in their home language while building new English language skills. She invites educators…

  1. Hospital revenue cycle management and payer mix: do Medicare and Medicaid undermine hospitals' ability to generate and collect patient care revenue?

    PubMed

    Rauscher, Simone; Wheeler, John R C

    2010-01-01

    The continuing efforts of government payers to contain hospital costs have raised concerns among hospital managers that serving publicly insured patients may undermine their ability to manage the revenue cycle successfully. This study uses financial information from two sources-Medicare cost reports for all US hospitals for 2002 to 2007 and audited financial statements for all bond-issuing, not-for-profit hospitals for 2000 to 2006 to examine the relationship between hospitals' shares of Medicare and Medicaid patients and the amount of patient care revenue they generate as well as the speed with which they collect their revenue. Hospital-level fixed effects regression analysis finds that hospitals with higher Medicare and Medicaid payer mix collect somewhat higher average patient care revenues than hospitals with more privately insured and self-pay patients. Hospitals with more Medicare patients also collect on this revenue faster; serving more Medicaid patients is not associated with the speed of patient revenue collection. For hospital managers, these findings may represent good news. They suggest that, despite increases in the number of publicly insured patients served, managers have frequently been able to generate adequate amounts of patient revenue and collect it in a timely fashion. PMID:21294440

  2. A proposed ethical framework for vaccine mandates: competing values and the case of HPV.

    PubMed

    Field, Robert I; Caplan, Arthur L

    2008-06-01

    Debates over vaccine mandates raise intense emotions, as reflected in the current controversy over whether to mandate the vaccine against human papilloma virus (HPV), the virus that can cause cervical cancer. Public health ethics so far has failed to facilitate meaningful dialogue between the opposing sides. When stripped of its emotional charge, the debate can be framed as a contest between competing ethical values. This framework can be conceptualized graphically as a conflict between autonomy on the one hand, which militates against government intrusion, and beneficence, utilitarianism, justice, and nonmaleficence on the other, which may lend support to intervention. When applied to the HPV vaccine, this framework would support a mandate based on utilitarianism, if certain conditions are met and if herd immunity is a realistic objective. PMID:18610781

  3. Mandated choice for organ donation: time to give it a try.

    PubMed

    Spital, A

    1996-07-01

    A severe shortage of organs greatly limits the ability to deliver the miracle of transplantation to people suffering from end-stage organ disease. Contributing to this shortage is a high rate of refusal among families who are asked for permission to remove organs from a recently deceased relative. Mandated choice offers an alternative to obtaining consent from the family by returning control to the individual. This plan would require all adults to record their wishes about posthumous organ donation and would consider those wishes binding. By moving the decision-making process to a relaxed setting and ensuring that a person's wishes would be honored, mandated choice would hopefully take advantage of favorable public attitudes toward donation and thereby facilitate organ procurement. Preliminary research suggests that public commitment to organ donation would increase under mandated choice. A pilot study of this promising proposal should be undertaken. PMID:8644990

  4. Depression case finding in primary care: a method for the mandates.

    PubMed

    Nease, Donald E; Klinkman, Michael S; Aikens, James E

    2006-01-01

    The current mandates for depression screening in primary care create a dilemma for clinicians. How should screening be implemented in the face of limited evidence for sustainable strategies for effective depression monitoring and management in primary care. In this article we review the issues surrounding primary care depression screening, and develop the argument for a case-finding strategy that includes careful choice of a single instrument, focused identification of high-risk patients, and systematic monitoring of outcomes. We believe this is a sustainable method that primary care clinicians can implement to address the spirit of current depression screening mandates. PMID:17154144

  5. Effect of criminal justice mandate on drug treatment completion among women

    PubMed Central

    2015-01-01

    Background Drug and alcohol abuse among women is a growing problem in the United States. Drug treatment is an effective way to manage the psychological, biological, financial, and social cost of drug abuse. Prior research has identified criminal justice referrals or coercion as a predictor of treatment completion among men but questions remain about the same effect in women. Objectives This study uses the Treatment Episodes Datasets Discharge 2006–2008 (TEDS-D) to explore the association between coercion and treatment completion among women. Methods Analysis compared primary treatment episodes of coerced women to those who entered treatment voluntarily. A logistic model of the odds of treatment success was performed controlling for race/ethnicity, age, education, employment, primary substance of abuse, number of substances reported at admission, referral source, treatment setting, and treatment duration. Results 582,671 primary treatment episodes were analyzed comparing women with coercion referrals (n=196,660) to those who entered treatment voluntarily (n=390,054). Results of multivariable logistic modeling showed that coerced women had better odds of completion or transfer than women who entered voluntarily. However, this association was modified by treatment setting with better odds in ambulatory (OR=1.49 (1.47, 1.51)) than in inpatient (OR=1.06 (1.03, 1.10)) and worst outcomes in detoxification (OR=0.89 (0.84, 0.96)). Conclusion These results dispute the broad effectiveness of legal mandates across all drug treatment settings among women. They show the need for further recognition of female specific characteristics that can affect motivation and treatment success to better inform healthcare and judicial policies on drug treatment services for women. PMID:24528184

  6. Does Mandating Nursing Home Participation In Quality Reporting Make A Difference? Evidence from Massachusetts

    PubMed Central

    Mukamel, Dana B.; Ye, Zhiqiu; Glance, Laurent G.; Li, Yue

    2015-01-01

    Background Quality report cards have been shown to be effective in influencing patients' referrals and promoting quality improvement in some instances and not others. In this study we investigate one of the mechanisms that may detract from their effectiveness: voluntary versus mandatory participation of nursing homes in public quality reporting. Objectives To answer two questions: 1) Were the nursing homes choosing not to participate low quality performers relative to those who chose to participate? 2) Once participation became mandatory, did those that did not voluntarily participate initially, improve more than those that participated voluntarily? Research Design Massachusetts published the Massachusetts Satisfaction Survey report card for nursing homes for the years 2005, 2007, and 2009. Nursing homes' participation was voluntary in 2005 and mandatory in 2007 and 2009. We performed a retrospective statistical analysis of the relationship between nursing homes' decision to participate in quality reporting and 12 quality outcomes: deficiency citations, staffing, and 8 survey domains. Subjects 424 Massachusetts nursing homes. Results 67% of nursing homes participated in reporting voluntarily. Volunteer nursing homes had better quality for all measures (significant at the 0.05 level or trending towards significance at the 0.10 level for all but 2). Once reporting became mandatory, non-volunteers improved more than volunteers in all but 2 staffing measures (trending towards significance at the 0.10 level in 5). Conclusions Report cards are more effective if nursing homes' participation is mandated. Non-mandatory reporting systems, as those implemented by some states and professional associations, lead to missed opportunities for quality improvements. PMID:26125418

  7. Plasma for fractionation in a public setting: cost analysis from the perspective of the third-party payer

    PubMed Central

    Eandi, Mario; Gandini, Giorgio; Povero, Massimiliano; Zaniolo, Orietta; Pradelli, Lorenzo; Aprili, Giuseppe

    2015-01-01

    Background In Italy, within the legal mandate to pursue national self-sufficiency of plasma-derived medical products, the Regions are starting to organise trade to offset imbalances between need and availability. It is, therefore, necessary to determine the full cost to the Regions of plasma collection and handling. Here we report an analysis of plasma production costs in the Department of Transfusion Medicine of Verona Province, Veneto Region. Materials and methods Plasma is obtained from voluntary, non-remunerated donors from either whole blood or apheresis donation, and in Verona it is collected, validated and distributed only in Regional Health Service facilities, and then delivered to industry for processing. The amounts and costs of materials and activities needed to collect, produce, validate and distribute plasma were obtained from the Department of Transfusion Medicine. Attributable overhead expenses were assumed at 15% of direct costs. When plasma was collected as part of whole blood or from multi-component apheresis, joint costs (the costs of the common manufacturing process before the separation) were allocated to the plasma based on the tariff for single components, taken as proxy of the willingness to pay for them. In an alternative scenario plasma recovered from whole blood donations was considered a by-product. Results The estimated full cost of each valid unit of plasma derived from whole blood, multi-component apheresis, and plasma-apheresis was about € 30, € 73 and € 170, respectively. The estimated total cost per litre of plasma was € 113 for collection from whole blood and € 276 for collection from apheresis. When plasma recovered from whole blood donations was considered a by-product, its cost per litre was estimated to be € 26. Discussion Our results suggest that the Italian donor-based system, in addition to its ethical and social values, can supply plasma at an affordable cost, comparable (albeit slightly higher) with costs in

  8. Examining Future Adolescent HPV Vaccine Uptake With and Without a School Mandate

    PubMed Central

    Dempsey, Amanda F.; Mendez, David

    2009-01-01

    Purpose To develop a model of adolescent HPV vaccine utilization that explored future HPV vaccination rates with and without a school mandate for the vaccine at middle school entry. Methods A dynamic, population-based, compartmental model was developed that estimated over a 50 year time horizon HPV vaccine uptake among female adolescents living in the U.S. The model incorporated data on parental attitudes about this vaccine and adolescent health care utilization levels. Results Without a mandate, our model predicted that 70% coverage, a lower threshold value used in many previous modeling studies of HPV vaccination, would not be achieved until a mean of 23 years after vaccine availability. Maximal coverage of 79% was achieved after 50 years. With a school mandate in place, utilization increased substantially, with 70% vaccination coverage achieved by year 8 and maximal vaccination coverage, 90%, achieved by year 43. Conclusions Our results suggest that vaccine utilization is likely to be low for several years, though strong school mandates might improve HPV vaccine uptake. These results impact the interpretation of previous modeling studies that estimated the potential clinical impacts of HPV vaccination under assumptions of very high vaccine utilization rates. PMID:20708562

  9. Federal Rule Yields Hope for Science: Testing Mandate Is Expected to Increase Time for Subject

    ERIC Educational Resources Information Center

    Cavanagh, Sean

    2007-01-01

    Some proponents of science education say they have faced no greater foe over the past few years than federally mandated tests in reading and mathematics, which have forced teachers to devote increasingly bigger chunks of class time to building students' skills in those two subjects. But if testing has squeezed science out, can testing also bring…

  10. Changes in Intimate Partner Violence among Women Mandated to Community Services

    ERIC Educational Resources Information Center

    Macy, Rebecca J.; Rizo, Cynthia F.; Guo, Shenyang; Ermentrout, Dania M.

    2013-01-01

    Increasingly, female victims of intimate partner violence (IPV) are charged with IPV perpetration and mandated by courts or child protective services to receive domestic violence services. A critical need exists for evidence-based interventions targeting the needs of this unique population, but such research is scarce. To address this gap, we…

  11. Urban Educators' Perceptions of Culturally Relevant Pedagogy and School Reform Mandates

    ERIC Educational Resources Information Center

    Esposito, Jennifer; Davis, Corrie L.; Swain, Ayanna N.

    2012-01-01

    In this article, we examine urban teachers' perceptions of school reform models (SRMs) and culturally relevant pedagogy (CRP). In particular, we examined how urban educators altered mandated reform models in the best interests of their culturally and linguistically diverse students. We discuss data from a phenomenological study, which included…

  12. A College Administrator's Framework to Assess Compliance with Accreditation Mandates

    ERIC Educational Resources Information Center

    Davis†, Jerry M.; Rivera, John-Juan

    2014-01-01

    A framework to assess the impact of complying with college accreditation mandates is developed based on North's (1996) concepts of transaction costs, property rights, and institutions; Clayton's (1999) Systems Alignment Model; and the educational production function described by Hanushek (2007). The framework demonstrates how sought…

  13. Theme and Variations: One Middle School's Interpretation of Mandated Action Research

    ERIC Educational Resources Information Center

    Sheridan-Thomas, Heather K.

    2006-01-01

    In the current climate of accountability, action research is one way for teachers to evaluate instructional changes designed to improve assessment results. It may become increasingly common for administrators to mandate teacher involvement in action research, yet few studies have been conducted in such settings. This article focuses on one middle…

  14. The Costs of Federally Mandated Social Regulations to Institutions of Higher Education in Texas.

    ERIC Educational Resources Information Center

    Thornton, Nelson L., Jr.

    The cost and impact of institutions of higher education in Texas when implementing and administering federally mandated social regulations were studied. All of the 156 institutions of higher education in Texas were sent questionnaires, and 108 responded. Findings include the following: the total dollar costs for implementing and administering…

  15. Perils ahead: employers cheer mandate's delay, but move leaves ACA open to new attacks.

    PubMed

    Block, Jonathan; Daly, Rich

    2013-07-01

    When the Obama administration announced it was delaying enforcement of the employer mandate in the ACA for one year, employer groups celebrated. But others had some troubling questions. "One has to hope, however, that the administration has thought through the ramifications of this delay for the other provisions," says Tim Jost, left, a law professor at Washington & Lee University. PMID:23878915

  16. Federal Policy Mandating Safer Cigarettes: A Hypothetical Simulation of the Anticipated Population Health Gains or Losses

    ERIC Educational Resources Information Center

    Tengs, Tammy O.; Ahmad, Sajjad; Moore, Rebecca; Gage, Eric

    2004-01-01

    If manufacturing a safer cigarette is technically possible--an open question--then mandating that tobacco manufacturers improve the safety of cigarettes would likely have both positive and negative implications for the nation's health. On the one hand, removing toxins may reduce the incidence of smoking-related diseases and premature mortality in…

  17. Challenges to the Integrity of Science: The Federal Mandate and Issues for Institutions.

    ERIC Educational Resources Information Center

    Hansen, Barbara C.; Hansen, Kenneth D.

    1989-01-01

    A discussion of scientific fraud and research misconduct looks at the federal mandate for more effective control by institutions and sponsoring agencies, the response of higher education associations, and issues awaiting consensus development, including anonymous reports, protection of the "whistle-blower," legal representation, and the nature of…

  18. Prospects: The Congressionally Mandated Study of Educational Growth and Opportunity. The Interim Report.

    ERIC Educational Resources Information Center

    Puma, Michael J.; And Others

    This publication is the first interim report from the Congressionally Mandated Study of Educational Growth and Opportunity (Prospects), and describes students' characteristics and the schools they attend. Prospects is designed to evaluate the short- and long-term consequences of Chapter 1 program participation by following for 5 years large…

  19. The Reading First Program and Statewide-Mandated Assessments: A Three-Year Comparative Study

    ERIC Educational Resources Information Center

    Ratcliff, Monica Wong; Powell, Sherlyn Ezell; Cage, Bob N.; Chen, Cheng C.

    2011-01-01

    This three-year comparative study investigated the impact of the Reading First (RF) Program on student performance as measured by statewide-mandated English Language Arts (ELA) assessment programs. A matching procedure was used where 3 RF schools and 3 non-RF schools from two rural school districts in north Louisiana were matched. The ELA test…

  20. SEC-Mandated Disclosure and Corporate Free Speech: A Critical Perspective.

    ERIC Educational Resources Information Center

    Van Slyke, Judy K.

    Disclosure of information to the investing public is a primary purpose of federal regulation of the securities industry and one of the primary duties and responsibilities of financial public relations practitioners. Disclosure requirements are numerous, with most mandating publicly held corporations to disclose information. Some requirements,…

  1. The Impact of a Universal Class-Size Reduction Policy: Evidence from Florida's Statewide Mandate

    ERIC Educational Resources Information Center

    Chingos, Matthew M.

    2012-01-01

    Class-size reduction (CSR) mandates presuppose that resources provided to reduce class size will have a larger impact on student outcomes than resources that districts can spend as they see fit. I estimate the impact of Florida's statewide CSR policy by comparing the deviations from prior achievement trends in districts that were required to…

  2. More than "An Apple a Day": New Mandates for School Wellness

    ERIC Educational Resources Information Center

    Woods, Amelia Mays; Weasmer, Jerie

    2006-01-01

    In this article, the authors discuss how, due to the increasing problems of obesity and sedentary lifestyles among children, schools have been mandated to instruct students on the importance of good nutritional habits and daily physical activity. Approaches to stimulating faculty to integrate wellness concepts and activities into curricula depend…

  3. Educational Alliance: The Importance of Relationships in Adult Education with Court-Mandated Students

    ERIC Educational Resources Information Center

    Mottern, Ron

    2012-01-01

    This conceptual study examines the importance of relationships between teachers and students in court-mandated adult education settings. Although research has been done on the importance of relationships between teachers and incarcerated students, there have been no outstanding studies on the relationships developed between teachers and students…

  4. The Usefulness of Accreditation-Mandated Outcomes Assessment in College Foreign Language Education

    ERIC Educational Resources Information Center

    Davis, John McE.

    2012-01-01

    This dissertation investigated the extent to which accreditation-mandated assessment capacity contributes to assessment use in tertiary foreign language (FL) programs. Four research questions were posed to pursue this concern: What is the nature and extent of assessment capacity in college FL programs? Which assessment uses are occurring in…

  5. The Games Concept Approach (GCA) as a Mandated Practice: Views of Singaporean Teachers

    ERIC Educational Resources Information Center

    Rossi, Tony; Fry, Joan M.; McNeill, Mike; Tan, Clara W. K.

    2007-01-01

    This paper reports on the views of Singaporean teachers of a mandated curriculum innovation aimed at changing the nature of games pedagogy within the physical education curriculum framework in Singapore. Since its first appearance over 20 years ago, Teaching Games for Understanding (TGfU), as an approach to games pedagogy has gathered support…

  6. What "Hard Times" Means: Mandated Curricula, Class-Privileged Assumptions, and the Lives of Poor Children

    ERIC Educational Resources Information Center

    Dutro, Elizabeth

    2010-01-01

    In this article, I present a qualitative analysis of third graders' experiences with a unit from their district-mandated commercial reading curriculum in which the children made strong connections between a fictional account of a Depression-era farm family's economic hardships and their own 21st century lives in a city with one of the highest…

  7. South African Educators' Mutually Inclusive Mandates to Promote Human Rights and Positive Discipline

    ERIC Educational Resources Information Center

    Coetzee, Susan; Mienie, Cathrine

    2013-01-01

    South African educators are mandated by international and national law to observe and promote human rights. However, given the realities of the limited teaching time available, educators cannot fulfill this obligation solely by teaching the curriculum. Another avenue needs to be found for educators to fulfill this obligation. Educators are also…

  8. TITLE CONSULTANCY: COORDINATED USE OF SDWA AND CWA MANDATES IN PUBLIC HEALTH PROTECTION

    EPA Science Inventory

    Description: This is a continuing series of consultations between the Office of Water and appropriate committees of the Science Advisory Board (SAB). There has been growing realization that to ensure safe drinking water it is necessary, and efficient, to use mandates of the Clea...

  9. Mandate Consultant: An Expert System for Examining the Implementation of Special Education Regulations. Technical Paper.

    ERIC Educational Resources Information Center

    Parry, James D.; And Others

    The role of artificial intelligence expert systems in administrative issues in special education is examined. Mandate Consultant (MC) is one such system designed to provide a second opinion on the consistency of school officials' actions in implementing the Individualized Education Program team process. MC employs rules based on the Education For…

  10. Administrators Mandating Mediation: Tools of Institutional Violence Cloaked in the Discourse of Reconciliation

    ERIC Educational Resources Information Center

    Herr, Kathryn

    2005-01-01

    Drawing on a critical incident, the practice of administrators mandating mediation as a means to resolve institutional conflicts is explored. The case is made that in relegating conceptual critique and disagreement to a psychologized space, individuals become the sites for change instead of the institution. The analysis is in keeping with…

  11. Addressing Alcohol Use and Problems in Mandated College Students: A Randomized Clinical Trial Using Stepped Care

    ERIC Educational Resources Information Center

    Borsari, Brian; Hustad, John T. P.; Mastroleo, Nadine R.; Tevyaw, Tracy O'Leary; Barnett, Nancy P.; Kahler, Christopher W.; Short, Erica Eaton; Monti, Peter M.

    2012-01-01

    Objective: Over the past 2 decades, colleges and universities have seen a large increase in the number of students referred to the administration for alcohol policies violations. However, a substantial portion of mandated students may not require extensive treatment. Stepped care may maximize treatment efficiency and greatly reduce the demands on…

  12. Working within the System: Teachers of English Learners Negotiating a Literacy Instruction Mandate

    ERIC Educational Resources Information Center

    Pease-Alvarez, Lucinda; Samway, Katharine Davies; Cifka-Herrera, Carrie

    2010-01-01

    In an effort to reverse the reading crisis purported to plague public education, schools and districts are mandating prescriptive reading programs and teacher-centered instructional practices in hopes of improving the academic achievement of minority students, including English learners (ELs). The wide-spread implementation of these programs in…

  13. Psychophysiological reactivity to emotional picture cues two years after college students were mandated for alcohol interventions.

    PubMed

    Buckman, Jennifer F; White, Helene R; Bates, Marsha E

    2010-08-01

    This study examined alcohol use behaviors as well as physiological, personality, and motivational measures of arousal in students approximately 2 years after they were mandated to a brief intervention program for violating university policies about on-campus substance use. Students were categorized into serious (medical referrals, n=13) or minor (residence advisor referrals, n=30) infraction groups based on the nature of the incident that led to their being mandated. Self-report measures of arousal, sensation seeking, reasons for drinking, and past 30-day alcohol use were completed. Physiological arousal during exposure to emotional picture cues was assessed by indices of heart rate variability. The minor infraction group reported significantly escalating alcohol use patterns over time and a pattern of less regulated psychophysiological reactivity to external stimuli compared to the serious infraction group. The serious infraction group was higher in sensation seeking and there was some evidence of greater disparity between their physiological and self-reported experiences of emotional arousal in response to picture cues than in the minor group. Thus, the two infraction groups represent different subsets of mandated students, both of whom may be at some risk for using alcohol maladaptively. The findings suggest that intervention strategies that address self-regulation may be beneficial for mandated college students. PMID:20409645

  14. Teachers as Mandated Reporters of Child Maltreatment: Comparison with Legal, Medical, and Social Services Reporters.

    ERIC Educational Resources Information Center

    Kesner, John E.; Robinson, Margaret

    2002-01-01

    Compares reports of child maltreatment made by education personnel with the three other groups required to report. Results indicate that education personnel were responsible for 25 percent of the reports among the four mandated report sources, yet they had the lowest rate of substantiation. Potential reasons for these differences are suggested.…

  15. New Mandates and Imperatives in the Revised "ACA Code of Ethics"

    ERIC Educational Resources Information Center

    Kaplan, David M.; Kocet, Michael M.; Cottone, R. Rocco; Glosoff, Harriet L.; Miranti, Judith G.; Moll, E. Christine; Bloom, John W.; Bringaze, Tammy B.; Herlihy, Barbara; Lee, Courtland C.; Tarvydas, Vilia M.

    2009-01-01

    The first major revision of the "ACA Code of Ethics" in a decade occurred in late 2005, with the updated edition containing important new mandates and imperatives. This article provides interviews with members of the Ethics Revision Task Force that flesh out seminal changes in the revised "ACA Code of Ethics" in the areas of confidentiality,…

  16. Do Fourteenth Amendment Considerations Outweigh a Potential State Interest in Mandating Cochlear Implantation for Deaf Children?

    ERIC Educational Resources Information Center

    Bender, Denise G.

    2004-01-01

    Currently, the decision concerning pediatric cochlear implantation for children remains a personal choice for parents to make. Economic factors, educational outcomes, and societal attitudes concerning deafness could result in an increased governmental interest in this choice. This article examines case law related to the issue of parental autonomy…

  17. Block Scheduling Effects on a State Mandated Test of Basic Skills.

    ERIC Educational Resources Information Center

    Veal, William R.; Schreiber, James

    1999-01-01

    Examined the effects of a tri-schedule (traditional, 4x4 block, and hybrid) schedules running at the same time on the academic achievement of 327 high school students. Discusses implications of findings for schools considering block scheduling. (SLD)

  18. Understanding Local Instructional Responses to Federal and State Accountability Mandates: A Typology of Extended Learning Time

    ERIC Educational Resources Information Center

    Midkiff, Brooke; Cohen-Vogel, Lora

    2015-01-01

    For the past dozen years, the federal government has held schools accountable for students' achievement in reading and mathematics. Schools that have not demonstrated improved student scores have faced heavy sanctions, including reconstitution and closure. In response to this high-stakes environment, schools appear to have extended the time…

  19. A Nationwide Survey of State-Mandated Evaluation Practices for Domestic Violence Agencies

    ERIC Educational Resources Information Center

    Riger, Stephanie; Staggs, Susan L.

    2011-01-01

    Many agencies serving survivors of domestic violence are required to evaluate their services. Three possible evaluation strategies include: a) process measurement, which typically involves a frequency count of agency activities, such as the number of counseling hours given; b) outcome evaluation, which measures the impact of agency activities on…

  20. Prediction of State Mandated Assessment Mathematics Scores from Computer Based Mathematics and Reading Preview Assessments

    ERIC Educational Resources Information Center

    Costa-Guerra, Boris

    2012-01-01

    The study sought to understand whether MAPs computer based assessment of math and language skills using MAPs reading scores can predict student scores on the NMSBA. A key question was whether or not the prediction can be improved by including student language skill scores. The study explored the effectiveness of computer based preview assessments…

  1. In-session Processes of Brief Motivational Interventions in Two Trials with Mandated College Students

    PubMed Central

    Borsari, Brian; Apodaca, Timothy R.; Jackson, Kristina; Mastroleo, Nadine; Magill, Molly; Barnett, Nancy P.; Carey, Kate B.

    2014-01-01

    Objective Each year, thousands of college students receive mandated intervention as a sanction for alcohol use or alcohol-related behavior. For these mandated students, Brief Motivational Interventions (BMIs) are currently the most efficacious individual intervention. However, little is known about how the technical (therapist behaviors) and relational (e.g., global ratings of therapist empathy) components of BMIs influence client language as well as subsequent change in alcohol use and consequences in mandated students. Method This study used the Motivational Interviewing Skills Code (MISC 2.0; Miller, Moyers, Ernst, & Amrhein, 2003) to code BMI sessions from two randomized clinical trials that facilitated significant reductions in alcohol use (Study 1, n = 91) and alcohol-related consequences (Study 2, n = 158) in mandated students. Results There were significant relationships among therapist behaviors, global scores, and client language both for and against change, yet there were no links between in-session client language and subsequent changes in alcohol use or problems. In contrast, relational aspects of MI (global ratings of therapist MI Spirit and client self-exploration) were most predictive of post-session alcohol use. Mediation models incorporating both technical and relational components revealed that higher levels of client self-exploration mediated the relationship between higher therapist ratings of MI Spirit and improved drinking at follow-up. Conclusions Findings highlight the importance of considering how both technical and relational components of MI may influence alcohol use in mandated college students, and also suggest more exact analyses to better understand this complex relationship. PMID:25111429

  2. Health behaviors of mandated and voluntary students in a motivational intervention program☆

    PubMed Central

    Kazemi, Donna M.; Levine, Maureen J.; Dmochowski, Jacek; Roger Van Horn, K.; Qi, Li

    2015-01-01

    College students engage in many unhealthy behaviors, one of these, heavy alcohol use, is a major global public health problem. Objective This longitudinal study examined whether students' mandated/voluntary status in a program to reduce college drinking was associated with overall health, ethnicity, gender, and personality traits. Both mandated and voluntary groups participated in the Motivational Intervention (MI) program to prevent high risk drinking. Methods Freshmen (710 voluntary, 190 mandated, n = 900) between the ages of 18 and 21, received the MI at baseline and again at 2 weeks, with boosters at 3, 6 and 12 months. Participants completed three measures: the Daily Drinking Questionnaire (DDQ); the Substance Use Risk Profile Scale (SURPS), and the Health Promoting Lifestyle Profile II (HPLPII). Mandated and voluntary participants were compared at baseline and following the intervention using two sample t-tests for continuous variables (overall health, personality traits, drinking measures), and chi-square for categorical variables (gender, ethnicity). Linear mixed models were used to identify associations between HPLP II scores and mandated/voluntary status, time, ethnicity gender and SURPS scale scores. Results In both groups, alcohol consumption dropped significantly by 12 months. Overall health-promoting behaviors, physical activity, stress management, and interpersonal relations improved in both groups between baseline and 12 months. Associations were found between alcohol consumption, personality traits, gender, and lifestyle health-promoting behaviors. In particular, impulsivity and hopelessness were associated with poor health behaviors. Conclusions Intervention programs to reduce drinking by college students need to address developmental dynamics of freshmen students, including gender, psychosocial factors, personality, and lifestyle health-promoting behaviors. PMID:26844100

  3. Insights into Education's Race to the Top: Correlational Survey Exploring Perceptions of Organizational Culture and Change Ambivalence during the Implementation of a Mandated Performance Evaluation System in a Northeast U.S. School District

    ERIC Educational Resources Information Center

    Schwamb, Andrea B.

    2013-01-01

    American public schools are currently facing a new mandated evaluation system that will create substantial change by requiring districts to evaluate professional staff based on two quantified measures: (a) state testing, and (b) a district determined measure. Although reforms have been at the forefront of policymakers' agendas, these initiatives…

  4. The decision-making processes adopted by rurally located mandated professionals when child abuse or neglect is suspected.

    PubMed

    Francis, Karen; Chapman, Ysanne; Sellick, Kenneth; James, Ainlsey; Miles, Maureen; Jones, Janet; Grant, Julie

    2012-04-01

    The reporting of suspected child abuse and neglect is a mandated role of medical doctors, nurses, police and teachers in Victoria, Australia. This paper reports on a research study that sought to explicate how mandated professionals working in rural Victorian contexts identify a child/ren at risk and the decisions they make subsequently. PMID:22724907

  5. 42 CFR 137.73 - What provisions of Title V apply to statutorily mandated grants added to the funding agreement?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false What provisions of Title V apply to statutorily mandated grants added to the funding agreement? 137.73 Section 137.73 Public Health PUBLIC HEALTH SERVICE... mandated grants added to the funding agreement? None of the provisions of Title V apply....

  6. 42 CFR 137.73 - What provisions of Title V apply to statutorily mandated grants added to the funding agreement?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false What provisions of Title V apply to statutorily mandated grants added to the funding agreement? 137.73 Section 137.73 Public Health PUBLIC HEALTH SERVICE... mandated grants added to the funding agreement? None of the provisions of Title V apply....

  7. 42 CFR 137.73 - What provisions of Title V apply to statutorily mandated grants added to the funding agreement?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What provisions of Title V apply to statutorily mandated grants added to the funding agreement? 137.73 Section 137.73 Public Health PUBLIC HEALTH SERVICE... mandated grants added to the funding agreement? None of the provisions of Title V apply....

  8. 42 CFR 137.73 - What provisions of Title V apply to statutorily mandated grants added to the funding agreement?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false What provisions of Title V apply to statutorily mandated grants added to the funding agreement? 137.73 Section 137.73 Public Health PUBLIC HEALTH SERVICE... mandated grants added to the funding agreement? None of the provisions of Title V apply....

  9. 42 CFR 137.73 - What provisions of Title V apply to statutorily mandated grants added to the funding agreement?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false What provisions of Title V apply to statutorily mandated grants added to the funding agreement? 137.73 Section 137.73 Public Health PUBLIC HEALTH SERVICE... mandated grants added to the funding agreement? None of the provisions of Title V apply....

  10. Vision 2000: A Framework for Reviewing the Mandate of Ontario's System of Colleges of Applied Arts and Technology.

    ERIC Educational Resources Information Center

    Ontario Council of Regents, Toronto.

    An introduction is provided to Vision 2000, a project initiated by Ontario's Minister of Colleges and Universities to review the mandate of the province's Colleges of Applied Arts and Technology (CAAT). Section 1 discusses the challenges facing Ontario's educational system, the minister's mandate to the CAAT Council of Regents, and the objectives…

  11. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  12. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  13. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  14. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  15. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  16. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  17. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  18. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  19. 42 CFR 137.66 - May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false May a Self-Governance Tribe keep interest earned on...-GOVERNANCE Statutorily Mandated Grants § 137.66 May a Self-Governance Tribe keep interest earned on statutorily mandated grant funds? Yes, a Self-Governance Tribe may keep Interest Earned on...

  20. 42 CFR 137.67 - How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false How may a Self-Governance Tribe use interest earned on statutorily mandated grant funds? 137.67 Section 137.67 Public Health PUBLIC HEALTH SERVICE... SELF-GOVERNANCE Statutorily Mandated Grants § 137.67 How may a Self-Governance Tribe use...

  1. Does the U.S. biofuels mandate increase the price at the pump?

    NASA Astrophysics Data System (ADS)

    Bolotin, Stephen R.

    The Renewable Fuel Standard (RFS) as amended by the Energy Independence and Security Act of 2007 created a federal mandate for blending conventional biofuels like corn-based ethanol and advanced biofuels like biodiesel and renewable gasoline into the United States transportation fuel supply. The RFS established yearly blending standards for the obligated parties--refiners and importers of petroleum products--that increase progressively until reaching a high of 36 billion gallons by 2022. Each ethanol-equivalent gallon of biofuel blended is assigned a unique Renewable Identification Number (RIN) through the Environmental Protection Agency's (EPA) Moderated Transaction System (EMTS). At year's close, obligated parties must submit their allotted RIN obligations to the EPA to demonstrate compliance. In the case of under-compliance or over-compliance, RINs can be traded between obligated parties freely through the EMTS or carried over for use in the next year. It follows, then, that a RIN carries a market value reflective of the cost of complying with RFS regulations. Indeed, most biofuels cost more than their fossil-based equivalents. When the price of a corn ethanol RIN went from 2-3 cents each in 2012 to nearly $1.50 in July of 2013 due to a perceived shortage in corn ethanol RINs, obligated parties faced the prospect of multimillion-dollar compliance cost increases. Arguing that RFS makes fuel significantly more expensive for consumers, petroleum companies have begun to advocate for the full repeal of the RFS, winning over some allies in Congress. The future of this program is uncertain. In an attempt to quantify the concerns of RFS critics, this thesis estimated the effect that RIN prices have on the wholesale cost of diesel fuel. Using daily price data from January 2011 through August of 2013 on RINs and crude oil, I specified twelve OLS regression models that predict the passthrough of the diesel RIN price to wholesale diesel price. My statistical analysis

  2. Randomized Controlled Trial of BASICS for Heavy Drinking Mandated and Volunteer Undergraduates: 12-Month Outcomes

    PubMed Central

    Terlecki, Meredith A.; Buckner, Julia D.; Larimer, Mary E.; Copeland, Amy L.

    2014-01-01

    This is the first randomized trial testing whether heavy drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy drinking volunteers up to one year post-intervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; Mage = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months post-intervention. At 4 weeks post-intervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer) BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). BASICS had a large effect on decreases in alcohol problems (d = .87). At 12 months post-intervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared to controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to one year post-intervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students. PMID:25844834

  3. Incident-specific and individual-level moderators of brief intervention effects with mandated college students.

    PubMed

    Mastroleo, Nadine R; Murphy, James G; Colby, Suzanne M; Monti, Peter M; Barnett, Nancy P

    2011-12-01

    Brief Motivational Interventions (BMI) and Computer-delivered interventions (CDI) have been successful in reducing drinking behaviors with mandated college students. However, research examining moderators of intervention effects have found mixed results. The current study sought to replicate and extend the research on moderators of intervention efficacy with mandated students. Baseline alcohol-related problems, readiness to change, gender, incident consequences, and participant responses to the event (personal attributions about the incident, aversiveness of the incident) were examined as moderators of intervention and booster condition efficacy on alcohol use and problems. Mandated students (N = 225) were randomized to complete either a BMI or CDI (Alcohol 101; Century Council, 1998), with or without a 1-month booster session, following a campus alcohol sanction. Outcomes were measured three months after baseline. Attributions moderated intervention condition such that participants low in personal attributions for their incident showed significantly less drinking following a CDI than a BMI. Men and individuals who reported low incident aversiveness showed higher drinks per occasion after receiving a booster, while individuals high in alcohol-related problems reported fewer heavy drinking days after completing a booster session. Findings suggest that identifying specific characteristics related to the precipitating event may inform intervention approaches in this high-risk population; however, additional research is needed to offer concrete guidance to practitioners in the field. PMID:21766975

  4. 77 FR 19414 - Pipeline Safety: Public Comment on Leak and Valve Studies Mandated by the Pipeline Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... Studies Mandated by the Pipeline Safety, Regulatory Certainty, and Job Creation Act of 2011 AGENCY..., Regulatory Certainty, and Job Creation Act of 2011 has called for several commissioned studies and reports...

  5. Alcohol Use and Problems in Mandated College Students: A Randomized Clinical Trial Using Stepped Care

    PubMed Central

    Borsari, Brian; Hustad, John T.P.; Mastroleo, Nadine R.; Tevyaw, Tracy O’Leary; Barnett, Nancy P.; Kahler, Christopher W.; Short, Erica Eaton; Monti, Peter M.

    2012-01-01

    Objective Over the past two decades, colleges and universities have seen a large increase in the number of students referred to the administration for alcohol policies violations. However, a substantial portion of mandated students may not require extensive treatment. Stepped care may maximize treatment efficiency and greatly reduce the demands on campus alcohol programs. Method Participants in the study (N = 598) were college students mandated to attend an alcohol program following a campus-based alcohol citation. All participants received Step 1: a 15-minute Brief Advice session that included the provision of a booklet containing advice to reduce drinking. Participants were assessed six weeks after receiving the Brief Advice, and those who continued to exhibit risky alcohol use (n = 405) were randomized to Step 2, a 60–90 minute brief motivational intervention (BMI) (n = 211) or an assessment-only control (n = 194). Follow-up assessments were conducted 3, 6, and 9 months after Step 2. Results Results indicated that the participants who received a BMI significantly reduced the number of alcohol-related problems compared to those who received assessment-only, despite no significant group differences in alcohol use. In addition, low risk drinkers (n = 102; who reported low alcohol use and related harms at 6-week follow-up and were not randomized to stepped care) showed a stable alcohol use pattern throughout the follow-up period, indicating they required no additional intervention. Conclusion Stepped care is an efficient and cost-effective method to reduce harms associated with alcohol use by mandated students. PMID:22924334

  6. Resuscitation and Obstetrical Care to Reduce Intrapartum-Related Neonatal Deaths: A MANDATE Study.

    PubMed

    Kamath-Rayne, Beena D; Griffin, Jennifer B; Moran, Katelin; Jones, Bonnie; Downs, Allan; McClure, Elizabeth M; Goldenberg, Robert L; Rouse, Doris; Jobe, Alan H

    2015-08-01

    To evaluate the impact of neonatal resuscitation and basic obstetric care on intrapartum-related neonatal mortality in low and middle-income countries, using the mathematical model, Maternal and Neonatal Directed Assessment of Technology (MANDATE). Using MANDATE, we evaluated the impact of interventions for intrapartum-related events causing birth asphyxia (basic neonatal resuscitation, advanced neonatal care, increasing facility birth, and emergency obstetric care) when implemented in home, clinic, and hospital settings of sub-Saharan African and India for 2008. Total intrapartum-related neonatal mortality (IRNM) was acute neonatal deaths from intrapartum-related events plus late neonatal deaths from ongoing intrapartum-related injury. Introducing basic neonatal resuscitation in all settings had a large impact on decreasing IRNM. Increasing facility births and scaling up emergency obstetric care in clinics and hospitals also had a large impact on decreasing IRNM. Increasing prevalence and utilization of advanced neonatal care in hospital settings had limited impact on IRNM. The greatest improvement in IRNM was seen with widespread advanced neonatal care and basic neonatal resuscitation, scaled-up emergency obstetric care in clinics and hospitals, and increased facility deliveries, resulting in an estimated decrease in IRNM to 2.0 per 1,000 live births in India and 2.5 per 1,000 live births in sub-Saharan Africa. With more deliveries occurring in clinics and hospitals, the scale-up of obstetric care can have a greater effect than if modeled individually. Use of MANDATE enables health leaders to direct resources towards interventions that could prevent intrapartum-related deaths. A lack of widespread implementation of basic neonatal resuscitation, increased facility births, and emergency obstetric care are missed opportunities to save newborn lives. PMID:25656720

  7. How Mandated College Students Talk About Alcohol: Peer Communication Factors Associated with Drinking.

    PubMed

    Carey, Kate B; Lust, Sarah A; Reid, Allecia E; Kalichman, Seth C; Carey, Michael P

    2016-09-01

    Relatively little research has examined how peer communication influences alcohol consumption. In a sample of mandated college students, we differentiate conversations about drinking from conversations about harm prevention and provide evidence for the validity of these communication constructs. Students who violated campus alcohol policies and were referred for alcohol sanctions (N = 345) reported on drinking patterns, use of protective behavioral strategies, perceived descriptive norms for close friends, and serving as social leader among their friends; they also reported on the frequency of conversations about drinking, about drinking safety, and about risk reduction efforts. Predicted correlations were found among types of communication and conceptually related variables. General communication was related to consumption but not protective behavioral strategies, whereas safety/risk reduction conversations correlated positively with all protective behavioral strategies. Both types of communication were associated with social leadership. Safety communication moderated the relationship between peer descriptive norms and drinks per week; more frequent talking about safety attenuated the norms-consumption relationship. Peer communication about both drinking and safety may serve as targets for change in risk reduction interventions for mandated college students. PMID:26861808

  8. What should be one's moral response to the HHS "contraceptive mandate"?

    PubMed

    Jerome Bracken, W

    2013-02-01

    This article asks how one should morally respond to the HHS contraceptive mandate which is now law and part of the Patient Protection and Affordable Care Act. This article first presents the historical background of the Obama Administration altering the government's 'final rule' for providing health services and protecting conscience rights. The mandate compels individuals and religious groups to provide insurance coverage for contraceptive, abortifacient, and sterilization services even though they are contrary to their values, and it narrowly defines what constitutes a religious group so fewer of them can claim exemption. Hence, the question is: Can individuals and religious groups obey the law without acting against their moral values or denying their religious identity? Using Church documents, the article answers that one cannot formally cooperate in evil but under certain conditions one can materially cooperate. The article uses the Summa Theologiae of Aquinas to explain what constitutes formal cooperation and how obeying the law can be material but not formal cooperation. It then examines whether the present conditions warrant material cooperation. It concludes that they do not and that religious groups are called to act as martyrs and give witness to their religious identity and moral values by resisting the law. PMID:24845754

  9. Re-conceptualising holism in the contemporary nursing mandate: from individual to organisational relationships.

    PubMed

    Allen, Davina

    2014-10-01

    Over the last forty years, nursing's claim to professional expertise has been expressed in terms of its care-giving function. Informed by a distinctive 'holistic' approach, models of nursing identify therapeutic relationships as the cornerstone of practice. While 'knowing the patient' has been central to clinicians' occupational identity, research reveals that nurses not only experience significant material constraints in realising these ideals, their contribution to healthcare extends far beyond direct work with patients. Amidst growing concern about healthcare quality, a body of critical commentary has emerged proposing that the contemporary nursing mandate, with its exclusive focus on care-giving, is no longer serving the interests of the profession or the public. Drawing on an ethnographic study of UK hospital nurses' 'organising work' and insights from practice-based approaches and actor network theory, this paper lays the foundations for a re-conceptualisation of holism within the nursing mandate centred on organisational rather than therapeutic relationships. Nurses can be understood as obligatory passage points in health systems and through myriad processes of 'translational mobilisation' sustain the networks through which care is organised. PMID:25181472

  10. Resource use and cost of care with biologicals in Crohn's disease in South Africa: a retrospective analysis from a payer perspective.

    PubMed

    Miot, Jacqui; Smith, Susan; Bhimsan, Niri

    2016-08-01

    Background Crohn's disease is a relapsing remitting inflammatory disease of the gastrointestinal tract. Treatment may require expensive biological therapy in severe patients. Affordability of the high cost anti-TNF-α agents has raised concern although evidence suggests cost-offsets can be achieved. There is little information on the resource utilisation of Crohn's patients in low and middle income countries. Objective The objective of this study is to investigate the resource utilisation and costs associated with biologicals treatment of Crohn's disease. Setting The setting for this study is in private healthcare in South Africa from a payer perspective. Method A retrospective longitudinal analysis of an administrative claims database from a large private healthcare insurer of patients who had at least 1 year claims exposure prior to starting biologicals and 2 years follow-up thereafter. Resource utilisation and costs including total Crohn's costs, hospital admissions and surgery, out of hospital costs, biologicals and chronic medicines were analysed. Main outcome measure The primary objective was to compare the change in resource utilisation and costs for Crohn's related conditions before and after starting biological treatment. Results A cohort of 72 patients was identified with a 35% (p = 0.005) reduction in Crohn's related costs (excluding the cost of biologicals) from ZAR 55,925 (U$5369) 1 year before compared to ZAR 36,293 (U$3484) 2 years after starting biological medicines. However, inclusion of the cost of biologicals more than doubled the total costs to ZAR 150,915 (±91,642) U$14,488 (±8798) in Year 2. Significant reductions in out-of hospital Crohn's related spend was also observed. Conclusions A reduction in healthcare costs is seen following starting biologicals in patients with moderate to severe Crohn's disease. However, the high cost of biological therapy outweighs any possible savings achieved in other areas of healthcare utilisation. PMID

  11. Card Sorts, State Tests, and Meaningful Mathematics

    ERIC Educational Resources Information Center

    Chauvot, Jennifer B.; Benson, Sharon L. D.

    2008-01-01

    This article shares card-sorting activities that involve state-mandated test items to use with prospective and practicing mathematics teachers to teach about accountability measures while exploring reform-minded mathematics instruction recommendations. (Contains 2 figures.)

  12. The individual mandate as healthcare regulation: what the Obama Administration should have said in NFIB v. Sebelius.

    PubMed

    Moncrieff, Abigail R

    2013-01-01

    There was an argument that the Obama Administration's lawyers could have made--but didn't--in defending Obamacare's individual mandate against constitutional attack. That argument would have highlighted the role of comprehensive health insurance in steering individuals' healthcare savings and consumption decisions. Because consumer-directed healthcare, which reaches its apex when individuals self-insure, suffers from several known market failures and because comprehensive health insurance policies play an unusually aggressive regulatory role in attempting to correct those failures, the individual mandate could be seen as an attempt to eliminate inefficiencies in the healthcare market that arise from individual decisions to self-insure. This argument would done a better job than the Obama Administration's of aligning the individual mandate with existing Commerce Clause and Necessary and Proper Clause precedent, and it would have done a better job of addressing the conservative Justices' primary concerns with upholding the mandate. This Article lays out this forgone defense of the individual mandate. PMID:24494443

  13. State School Board Members and the State Education Policy System

    ERIC Educational Resources Information Center

    Sroufe, Gerald R.

    1971-01-01

    Discusses the contrast between the clear legal mandate for State boards of education to determine education for the State on the one hand, and their peculiarly ill-defined and tenuous role in the State policy system on the other. (JF)

  14. Evidence That The Citizenship Mandate Curtailed Participation In Oregon’s Medicaid Family Planning Program

    PubMed Central

    Angus, Lisa; DeVoe, Jennifer

    2016-01-01

    The 2005 federal Deficit Reduction Act made proof of citizenship a requirement for Medicaid eligibility. We examined the effects on visits to Oregon’s Medicaid family planning services eighteen months after the citizenship requirement was implemented. We analyzed 425,381 records of visits that occurred between May 2005 and April 2008 and found that, compared to the eighteen-month period before the mandate went into effect, visits declined by 33 percent. We conclude that Medicaid citizenship documentation requirements have been burdensome for Oregon Family Planning Expansion Project patients and costly for health care providers, reducing access to family planning and preventive measures and increasing the strain on the safety net. PMID:20368600

  15. Reasonable accommodation for employees with mental disabilities: a mandate for effective supervision?

    PubMed

    Hantula, D A; Reilly, N A

    1996-01-01

    Reasonable accommodation under Title I of the Americans with Disabilities Act (ADA) for employees with mental disabilities is explored from a behavior analytic perspective. Although much of the attention in issues of reasonable accommodation is concentrated on persons with physical disabilities, it is argued that the needs of individuals with mental disabilities are in greater need of further study. The criteria for successful accommodation in the workplace for employees with mental disabilities is seen to be structurally different, but functionally similar to successful accommodations for employees with physical disabilities, and is based on the development of enabling environments. Behavior analysis offers a theoretical basis and performance management presents a methodological basis for analyzing, developing, implementing, and evaluating reasonable accommodation for persons with mental disabilities, largely in terms of effective supervision. It is concluded that Title I of the ADA may be seen as providing a mandate for effective supervision, which may also be extended to all employees. PMID:10160232

  16. Class Size: What Research Says and What It Means for State Policy

    ERIC Educational Resources Information Center

    Whitehurst, Grover J.; Chingos, Matthew M.

    2011-01-01

    Class size is one of the small number of variables in American K-12 education that are both thought to influence student learning and are subject to legislative action. Legislative mandates on maximum class size have been very popular at the state level. In recent decades, at least 24 states have mandated or incentivized class-size reduction…

  17. When We Really Believe: How Louisiana's St. Tammany Parish School System Is Reconciling IDEIA with the NCLB Mandate

    ERIC Educational Resources Information Center

    Guilott, Maria C.; Parker, Gaylynn

    2010-01-01

    The "all children can learn" call to action made no exceptions when it appeared on the educational landscape, and educators began to shift their thinking to ensure that students with disabilities were challenged in academic achievement. Two federal mandates, not only No Child Left Behind (NCLB 2001) but also the Individuals with Disabilities…

  18. An Evaluation of Factors that Impact Positive School Climate for School Psychologists in a Time of Conflicting Educational Mandates

    ERIC Educational Resources Information Center

    Thompson, Melody J.; Crank, Joe N.

    2010-01-01

    Educators including school psychologists must negotiate the differing demands of legal mandates and recent educational initiatives that impact their practice and school climate in order to maintain positive effects for students and other school personnel. The No Child Left Behind (NCLB) Act of 2001, the Individuals with Disabilities Education Act,…

  19. Education Code Mandates of the Board of Governors and Chancellor's Office: Comments on Compliance and Recommendations for Change.

    ERIC Educational Resources Information Center

    Nussbaum, Tom

    This document is a compilation of California Education Code sections which set forth powers or duties of the Board of Governors or Chancellor's Office. Each power or duty is separately identified, followed by comments on the extent to which the mandate is being complied with, what the problems with compliance are, and recommendations as to changes…

  20. The Costs of Implementing Federally Mandated Social Programs at Colleges and Universities. Policy Analysis Service Special Report.

    ERIC Educational Resources Information Center

    Van Alstyne, Carol; Coldren, Sharon L.

    Federally mandated social programs that apply to colleges and universities because they are treated as business entities are covered in this report. These programs have contributed to the continually increasing operating costs of colleges and universities over the last decade. This study aims at providing quantified examples of these cost…

  1. Individual and Situational Factors that Influence the Efficacy of Personalized Feedback Substance Use Interventions for Mandated College Students

    ERIC Educational Resources Information Center

    Mun, Eun Young; White, Helene R.; Morgan, Thomas J.

    2009-01-01

    Little is known about individual and situational factors that moderate the efficacy of personalized feedback interventions (PFIs). Mandated college students (N = 348) were randomly assigned either to a PFI delivered in the context of a brief motivational interview (BMI; n = 180) or to a written PFI only (WF) condition and were followed up at 4…

  2. Understanding the Learner Who Is Court-Mandated To Learn. Practitioner Research Briefs, 1999-2000 Report Series.

    ERIC Educational Resources Information Center

    Flowers, Susan

    A project was conducted to determine the thoughts and feelings of probationers (mostly white males ranging in age from early 20s to early 50s) mandated by a judge to complete their GED (General Educational Development) diploma or their high school diploma at a local adult education program mostly attended by middle-aged white female displaced…

  3. Effectiveness of the Brief Alcohol and Screening Intervention for College Students (BASICS) Program with a Mandated Population

    ERIC Educational Resources Information Center

    DiFulvio, Gloria T.; Linowski, Sally A.; Mazziotti, Janet S.; Puleo, Elaine

    2012-01-01

    Objective: This study evaluated the effectiveness of a large-scale intervention designed to reduce alcohol abuse among adjudicated college students. Participants: Participants were college students mandated to attend a Brief Alcohol Screening and Intervention for College Students (BASICS) program and a randomly selected comparison group of…

  4. Children Writing "Hard Times": Lived Experiences of Poverty and the Class-Privileged Assumptions of a Mandated Curriculum

    ERIC Educational Resources Information Center

    Dutro, Elizabeth

    2009-01-01

    Dutro discusses an analysis of the disconnect between the material realities of the lives of a group of third-grade children living in poverty and the middle-class assumptions of a district-mandated unit within a literacy curriculum. The analysis arose in the context of an ethnographic study of identity and classroom literacy practices; it was…

  5. A Call for Public Policy Review: Ensuring the Fairness and Accuracy of Mandated Tests. Test Equity Considerations: Public Policy

    ERIC Educational Resources Information Center

    PEPNet-West, 2010

    2010-01-01

    Public policy making relies on accurate information, but standardized and other mandated tests may not accurately evaluate the abilities and knowledge of individuals who are deaf or hard of hearing. Many individuals find tests difficult, but individuals who are deaf or hard of hearing may find them especially so. Reports from the 2008 Test Equity…

  6. Women Saw Large Decrease In Out-Of-Pocket Spending For Contraceptives After ACA Mandate Removed Cost Sharing.

    PubMed

    Becker, Nora V; Polsky, Daniel

    2015-07-01

    The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance. PMID:26153316

  7. "Deshaney" and Its Progeny--the Failure to Mandate That Public School Officials Protect Our Tender Youth.

    ERIC Educational Resources Information Center

    Journal of Law and Education, 1995

    1995-01-01

    A majority of federal courts have dismissed lawsuits involving children injured at school and have held that the Constitution does not mandate that affirmative steps should be taken to protect a child. Deals with both the legal and practical issues involved with such a decision. Argues that public school officials have an affirmative…

  8. Supporting Public High School Teachers in a Context of Multiple Mandates: A Social Justice Approach to Professional Learning Communities

    ERIC Educational Resources Information Center

    Harak, Philip J.

    2012-01-01

    Although public school teaching by its inherent nature presents numerous classroom challenges, the public high school teacher today is faced in addition with multiple external mandates from several outside stakeholders. Given the established track record of professional learning communities (PLCs) to provide teacher support and development, I…

  9. Finding the proper balance between freedom and justice: why we should not eliminate personal belief exemptions to vaccine mandates.

    PubMed

    Opel, Douglas J; Diekema, Douglas S

    2012-02-01

    Lantos and colleagues (this issue) propose to eliminate personal belief exemptions from school vaccine mandates, particularly for those vaccines that target deadly contagious childhood disease. They argue that not doing so would be unjust. In this counterpoint, we argue that, for reasons grounded in both health policy and morality, a just vaccine policy need not prohibit parents from claiming personal belief exemptions. PMID:22003099

  10. Exploring Asperger's Syndrome, Schlossberg's Transition Theory and Federally Mandated Transition Planning: Seeking Improvements

    ERIC Educational Resources Information Center

    Spencer, Tracy Lynne Wright Lyons

    2013-01-01

    Federally mandated transition planning has done little to improve the postsecondary outcomes of people with Asperger's syndrome. Current high school transition planning for students with Asperger's attempts to address some of these areas through family involvement, community inclusion, and the active participation of the student in…

  11. Positioning Teachers: A Discourse Analysis of Russian and American Teacher Identities in the Context of Changing National Assessment Mandates

    ERIC Educational Resources Information Center

    Ignatieva, Raisa P.

    2011-01-01

    The purpose of the study was to uncover the cultural beliefs and values that underlie American and Russian teachers' representations of their professional identities and their understanding of power in education in the context of globally disseminated education reforms and current educational mandates--the No Child Left Behind Act of 2001 (NCLB)…

  12. Evidence for a need to mandate kidney transplant living donor registries.

    PubMed

    Emara, Mahmoud; Ragheb, Ahmed; Hassan, Abubaker; Shoker, Ahmed

    2008-01-01

    Kidney disease is a global public health problem of growing proportions. Currently the best treatment for end-stage renal failure is transplantation. Living organ donation remains a complex ethical, moral and medical issue. It is based on a premise that kidney donation is associated with short-term minimal risks to harm the donor, and is outweighed by the definite advantages to the recipient. A growing number of patients with end-stage renal disease and shortage of kidney donors poses a pressing need to expand the criteria needed to accept kidney donors. The current donor registries are structured and are driven to expand donor pool. As living kidney donation is not without risks, more attention should be given to protect the donor health. After kidney donation, mild to moderate renal insufficiency may occur. Renal insufficiency, even mild, is associated with increased risks of hypertension, proteinuria and cardiovascular morbidity. We, therefore, foresee a need to mandate the establishment of renal transplant donor registries at all transplanting programs as a prerequisite to protect the long-term well being of kidney donors. These registries can collect the database necessary to develop standards of practice and guidelines for future kidney donation. PMID:18549448

  13. Sustain talk predicts poorer outcomes among mandated college student drinkers receiving a brief motivational intervention.

    PubMed

    Apodaca, Timothy R; Borsari, Brian; Jackson, Kristina M; Magill, Molly; Longabaugh, Richard; Mastroleo, Nadine R; Barnett, Nancy P

    2014-09-01

    Within-session client language that represents a movement toward behavior change (change talk) has been linked to better treatment outcomes in the literature on motivational interviewing (MI). There has been somewhat less study of the impact of client language against change (sustain talk) on outcomes following an MI session. This study examined the role of both client change talk and sustain talk, as well as therapist language, occurring during a brief motivational intervention (BMI) session with college students who had violated college alcohol policy (N = 92). Audiotapes of these sessions were coded using a therapy process coding system. A series of hierarchical regressions were used to examine the relationships among therapist MI-consistent and MI-inconsistent language, client change talk and sustain talk, as well as global measures of relational variables, and drinking outcomes. Contrary to prior research, sustain talk, but not change talk, predicted poorer alcohol use outcomes following the BMI at 3- and 12-month follow-up assessments. Higher levels of client self-exploration during the session also predicted improved drinking outcomes. Therapist measures of MI-consistent and MI-inconsistent language, and global measures of therapist acceptance and MI spirit were unrelated to client drinking outcomes. Results suggest that client sustain talk and self-exploration during the session play an important role in determining drinking outcomes among mandated college students receiving a BMI addressing alcohol use. PMID:25222170

  14. Perspectives on probation and mandated mental health treatment in specialized and traditional probation departments.

    PubMed

    Skeem, Jennifer L; Encandela, John; Louden, Jennifer Eno

    2003-01-01

    Despite the prevalence of mentally ill probationers, and probation officers' (POs') central role in their supervision, this is the first reported study to investigate how POs implement mandates to participate in psychiatric treatment. Five focus groups were conducted in major cities with 32 POs and 20 probationers representing a mix of traditional and "specialty" probation agencies. Three key findings resulted. First, there were considerable differences between POs in specialty and traditional agencies in the nature, range, and timing of strategies applied to monitor and enforce treatment compliance. Second, the quality of PO-probationer relationships colored POs' use of these strategies and was perceived as central to probationer outcomes. Relationships characterized by a respectful, personal, approach were perceived as more effective in achieving desired outcomes than those that were more authoritarian. Third, specialty agencies strongly emphasized offender rehabilitation whereas traditional agencies focused more exclusively on community safety. These agencies differed in how well probationers with mental illness "fit" their standard operating procedure. Implications for future research and directions for probation practice are discussed. PMID:12898501

  15. Affordable Care Act's Mandate Eliminating Contraceptive Cost Sharing Influenced Choices Of Women With Employer Coverage.

    PubMed

    Carlin, Caroline S; Fertig, Angela R; Dowd, Bryan E

    2016-09-01

    Patient cost sharing for contraceptive prescriptions was eliminated for certain insurance plans as part of the Affordable Care Act. We examined the impact of this change on women's patterns of choosing prescription contraceptive methods. Using claims data for a sample of midwestern women ages 18-46 with employer-sponsored coverage, we examined the contraceptive choices made by women in employer groups whose coverage complied with the mandate, compared to the choices of women in groups whose coverage did not comply. We found that the reduction in cost sharing was associated with a 2.3-percentage-point increase in the choice of any prescription contraceptive, relative to the 30 percent rate of choosing prescription contraceptives before the change in cost sharing. A disproportionate share of this increase came from increased selection of long-term contraception methods. Thus, the removal of cost as a barrier seems to be an important factor in contraceptive choice, and our findings about long-term methods may have implications for rates of unintended pregnancy that require further study. PMID:27605640

  16. Evolving trends in nurse regulation: what are the policy impacts for nursing's social mandate?

    PubMed

    Duncan, Susan; Thorne, Sally; Rodney, Patricia

    2015-03-01

    We recognize a paradox of power and promise in the context of legislative and organizational changes in nurse regulation which poses constraints on nursing's capacity to bring voice and influence to pressing matters of healthcare and public policy. The profession is at an important crossroads wherein leaders must be well informed in political, economic and legislative trends to harness the profession's power while also navigating forces that may put at risk its central mission to serve society. We present a critical policy analysis of the impact of recent regulatory trends on what the International Council of Nurses considers nursing's three 'pillars' - the profession of nursing, socioeconomic welfare of nurses and nurse regulation. Themes surfacing from this analysis include regulatory discontinuity, a tightening of regulatory control, and an increasingly managerial governance culture. These themes illuminate insights and strategies required to renew and revitalize the social mandate of our profession amidst a climate of urgency in the questioning of nurse scholars with respect to the future of the profession. At this historic juncture, nurses must clearly understand the implications of legislative and organizational regulatory changes to ensure the profession contributes to full capacity in achieving health and health equity globally. PMID:25382628

  17. Texas Nurse Staffing Trends Before and After Mandated Nurse Staffing Committees.

    PubMed

    Jones, Terry; Heui Bae, Sung; Murry, Nicole; Hamilton, Patti

    2015-08-01

    This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives. PMID:26667354

  18. Factors associated with probation officers' use of criminal justice coercion to mandate alcohol treatment.

    PubMed

    Polcin, Douglas L; Greenfield, Thomas K

    2003-08-01

    Alcohol problems are widespread among individuals in county criminal justice probation systems. However, it is unclear why only a small fraction of these problem drinkers receive treatment. In this study, self-administered questionnaires were mailed to 145 probation officers in nine California counties to identify factors that predicted probation officers' use of coercion to mandate alcohol treatment. The questionnaire measured characteristics of probation officers, characteristics of their caseloads, and perceptions about their departments. Principle components analysis combined some of the items into six factor-based scales. Multiple regression analyses identified two significant predictors of use of coercion into treatment: a belief that treatment was effective and a belief that one's peers in the department were using coercion frequently. Implications for increasing treatment entry of probationers with drinking problems include educating probation officers about the effectiveness of substance abuse treatment in general and about coerced treatment in particular. Probation departments are encouraged to develop management styles that facilitate shared normative beliefs about assessing and managing alcohol problems among probationers. PMID:14510045

  19. Rents From the Essential Health Benefits Mandate of Health Insurance Reform.

    PubMed

    Mendoza, Roger Lee

    2015-01-01

    The essential health benefits mandate constitutes one of the most controversial health care reforms introduced under the U.S. Affordable Care Act of 2010. It bears important theoretical and practical implications for health care risk and insurance management. These essential health benefits are examined in this study from a rent-seeking perspective, particularly in terms of three interrelated questions: Is there an economic rationale for standardized, minimum health care coverage? How is the scope of essential health services and treatments determined? What are the attendant and incidental costs and benefits of such determination/s? Rents offer ample incentives to business interests to expend considerable resources for health care marketing, particularly when policy processes are open to contestation. Welfare losses inevitably arise from these incentives. We rely on five case studies to illustrate why and how rents are created, assigned, extracted, and dissipated in equilibrium. We also demonstrate why rents depend on persuasive marketing and the bargained decisions of regulators and rentiers, as conditioned by the Tullock paradox. Insights on the intertwining issues of consumer choice, health care marketing, and insurance reform are offered by way of conclusion. PMID:26075546

  20. The FIGO working group on the prevention of unsafe abortion: mandate and process for achievement.

    PubMed

    Leke, Robert J I; de Gil, Marina Padilla; Távara, Luis; Faúndes, Anibal

    2010-07-01

    The Working Group of the International Federation of Gynecology and Obstetrics (FIGO) on the Prevention of Unsafe Abortion and its Consequences received a mandate to contribute to reduce the number of women who have to resort to induced abortion and the maternal mortality and morbidity associated with unsafe abortion by minimizing unintended pregnancies, improving access to safe abortion services, and increasing the quality of and access to post-abortion care, including post-abortion contraception. A project proposal was prepared and approved by an anonymous donor, funding a structure headed by a general coordinator, the Chair of the Working Group, together with 6 regional coordinators and 1 assistant regional coordinator, plus 43 focal points nominated by the participating societies. A situational analysis of induced/unsafe abortion for each country was prepared by the focal points with the technical support of the Guttmacher Institute, and a plan of action based on the findings of the analysis. The situational analysis and plans of action were discussed at 7 regional workshops held between June and August, 2008. Fifty-four member societies nominated a focal point, 48 attended the regional workshops, and 43 had a plan of action approved by their governments and respective societies. The plans of action are currently in the process of implementation, with the collaboration of a number of national and international agencies and organizations. PMID:20451200

  1. State Education Agency Civil Rights Responsibilities.

    ERIC Educational Resources Information Center

    Siegel, Peter

    This memorandum addresses the responsibility of State Education Agencies (SEAs) for insuring that local educational agencies do not violate students' civil rights. The SEA's duty is said to arise from two sources. First, in most if not all States, State law mandates that State education officials supervise and regulate the conduct of local school…

  2. The Lower-Order Expectations of High-Stakes Tests: A Four-State Analysis of Social Studies Standards and Test Alignment

    ERIC Educational Resources Information Center

    DeWitt, Scott W.; Patterson, Nancy; Blankenship, Whitney; Blevins, Brooke; DiCamillo, Lorrei; Gerwin, David; Gradwell, Jill M.; Gunn, John; Maddox, Lamont; Salinas, Cinthia; Saye, John; Stoddard, Jeremy; Sullivan, Caroline C.

    2013-01-01

    This study indicates that the state-mandated high-stakes social studies assessments in four states do not require students to demonstrate that they have met the cognitive demands articulated in the state-mandated learning standards. Further, the assessments do not allow students to demonstrate the critical thinking skills required by the…

  3. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  4. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  5. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  6. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  7. 42 CFR 137.65 - May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe receive statutorily mandated grant funding in an annual lump sum advance payment? 137.65 Section 137.65 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Statutorily Mandated Grants § 137.65 May a Self-Governance...

  8. A national long-term care program for the United States. A caring vision. The Working Group on Long-term Care Program Design, Physicians for a National Health Program.

    PubMed

    Harrington, C; Cassel, C; Estes, C L; Woolhandler, S; Himmelstein, D U

    1991-12-01

    The financing and delivery of long-term care (LTC) need substantial reform. Many cannot afford essential services; age restrictions often arbitrarily limit access for the nonelderly, although more than a third of those needing care are under 65 years old; Medicaid, the principal third-party payer for LTC, is biased toward nursing home care and discourages independent living; informal care provided by relatives and friends, the only assistance used by 70% of those needing LTC, is neither supported nor encouraged; and insurance coverage often excludes critically important services that fall outside narrow definitions of medically necessary care. We describe an LTC program designed as an integral component of the national health program advanced by Physicians for a National Health Program. Everyone would be covered for all medically and socially necessary services under a single public plan, federally mandated and funded but administered locally. An LTC payment board in each state would contract directly with providers through a network of local public agencies responsible for eligibility determination and care coordination. Nursing homes, home care agencies, and other institutional providers would be paid a global budget to cover all operating costs and would not bill on a per-patient basis. Alternatively, integrated provider organizations could receive a capitation fee to cover a broad range of LTC and acute care services. Individual practitioners could continue to be paid on a fee-for-service basis or could receive salaries from institutional providers. Support for innovation, training of LTC personnel, and monitoring of the quality of care would be greatly augmented. For-profit providers would be compensated for past investments and phased out. Our program would add between $18 billion and $23.5 billion annually to current spending on LTC. Polls indicate that a majority of Americans want such a program and are willing to pay earmarked taxes to support it. PMID

  9. Attitudes of Washington State physicians toward health care reform.

    PubMed Central

    Malter, A D; Emerson, L L; Krieger, J W

    1994-01-01

    Attitudes of Washington State physicians about health care reform and about specific elements of managed competition and single-payer proposals were evaluated. Opinions about President Clinton's reform plan were also assessed. Washington physicians (n = 1,000) were surveyed from October to November 1993, and responses were collected through January 1994; responses were anonymous. The response rate was 80%. Practice characteristics of respondents did not differ from other physicians in the state. Of physicians responding, 80% favored substantial change in the current system, 43% favored managed competition, and 40% preferred a single-payer system. Of physicians responding, 64% thought President Clinton's proposal would not adequately address current problems. Reduced administrative burden, a central element of single-payer plans, was identified by 89% of respondents as likely to improve the current system. Other elements of reform plans enjoyed less support. More procedure-oriented specialists than primary care physicians favored leaving the current system unchanged (28% versus 8%, P < .001). While physicians favor health care reform, there is no consensus on any single plan. It seems unlikely that physicians will be able to speak with a single voice during the current debates on health care reform. PMID:7941503

  10. Predictors of Motivation to Change in Mandated College Students Following a Referral Incident

    PubMed Central

    Qi, David; Pearson, Matthew R.; Hustad, John T. P.

    2014-01-01

    The purpose of present study was to understand factors that are related to a desire or motivation to change (MTC) alcohol use in a sample of college students mandated to receive an alcohol intervention. We examined characteristics of and reactions to the referral event, typical alcohol use involvement, and alcohol beliefs about the perceived importance of drinking in college (subsequently referred to as the “role of drinking”) assessed by the College Life Alcohol Salience Scale (CLASS; Osberg et al., 2010) as predictors of MTC following referral to an alcohol intervention. College students (N = 932) who presented for a mandatory alcohol intervention following a referral event (e.g., citation for underage drinking, medical attention for an alcohol-related incident, or driving under the influence) completed an assessment prior to receiving an alcohol intervention. Higher perceived aversiveness of the referral event and higher personal responsibility one felt for the occurrence of the event were positively related to higher MTC. Although alcohol beliefs about the role of drinking in college were not significantly related to either event aversiveness or responsibility, it was negatively related to MTC even after controlling for alcohol use involvement variables. Alcohol beliefs about the role of drinking in college represent an important construct that is related to increased alcohol use and alcohol-related problems and decreased MTC in a sample of college students. Interventions aimed at reducing alcohol beliefs about the role of drinking in college may be an effective strategy to reduce alcohol use and alcohol-related problems by college students. PMID:24750039

  11. Supporting Commission on Cancer–Mandated Psychosocial Distress Screening With Implementation Strategies

    PubMed Central

    Lazenby, Mark; Ercolano, Elizabeth; Grant, Marcia; Holland, Jimmie C.; Jacobsen, Paul B.; McCorkle, Ruth

    2015-01-01

    Purpose: The American College of Surgeons Commission on Cancer (CoC) has set psychosocial distress screening as a new patient care standard to be met by 2015. The standard requires CoC-accredited cancer centers to integrate and monitor distress screening and, when needed, refer patients to psychosocial health care services. We describe the uptake of distress screening reported by applicants to a distress screening cancer education program and the degree of and barriers to implementation of distress screening programs reported by selected participants. Materials and Methods: This cross-sectional study collected quantitative data online from applicants to the program between August 1 and November 15, 2013, described by frequencies, percentages, and measures of central tendency, and qualitative data in person from accepted participants on February 13, 2014, analyzed using an integrated approach to open-ended data. Results: Applications were received from 70 institutions, 29 of which had started distress screening. Seven of 18 selected applicant institutions had not begun screening patients for distress. Analysis of qualitative data showed that all participants needed to create buy-in among key cancer center staff, including oncologists; to decide how to conduct screening in their institution in a way that complied with the standard; and to pilot test screening before large-scale rollout. Conclusion: Fourteen months before the compliance deadline, fewer than half of applicant institutions had begun distress screening. Adding implementation strategies to mandated quality care standards may reduce uncertainty about how to comply. Support from key staff members such as oncologists may increase uptake of distress screening. PMID:25758447

  12. Statewide Mandatory Remediation Policies: National, State, and Institutional Perspectives

    ERIC Educational Resources Information Center

    Peak, Charity S.

    2012-01-01

    Despite uncertainty related to student outcomes resulting from remediation (Bettinger & Long, 2009), eleven states mandate remedial education through common placement testing and standardized cutoff scores rather than permitting individual postsecondary institutions to establish remediation guidelines. Colorado, in particular, offers an…

  13. Re-reading nursing and re-writing practice: towards an empirically based reformulation of the nursing mandate.

    PubMed

    Allen, Davina

    2004-12-01

    This article examines field studies of nursing work published in the English language between 1993 and 2003 as the first step towards an empirically based reformulation of the nursing mandate. A decade of ethnographic research reveals that, contrary to contemporary theories which promote an image of nursing work centred on individualised unmediated caring relationships, in real-life practice the core nursing contribution is that of the healthcare mediator. Eight bundles of activity that comprise this intermediary role are described utilising evidence from the literature. The mismatch between nursing's culture and ideals and the structure and constraints of the work setting is a chronic source of practitioner dissatisfaction. It is argued that the profession has little to gain by pursuing an agenda of holistic patient care centred on emotional intimacy and that an alternative occupational mandate focused on the healthcare mediator function might make for more humane health services and a more viable professional future. PMID:15601415

  14. Attorney work product privilege trumps mandated child abuse reporting law: The case of Elijah W. v. Superior Court.

    PubMed

    Lareau, Craig R

    2015-01-01

    Forensic psychologists and psychiatrists are licensed in their respective professions, but they perform most of their work with attorneys in the legal arena. Both attorneys and mental health professionals place high value on confidentiality of information, reflected in the ethics of their professions and codified into laws governing their work. In psychology and psychiatry, there are some well-known exceptions to confidentiality; two primary exceptions include the mandated reporting of suspected child abuse and various "Tarasoff" duty to warn or protect laws. Generally, however, the corresponding duty for attorneys to report suspected child abuse or to warn or protect intended victims of threatened harm is not as extensive. This difference in mandated reporting responsibilities can create significant difficulties when attorneys need to retain forensic psychologists and psychiatrists to evaluate their clients, especially in criminal contexts. If the retained psychologist or psychiatrist is required to report suspected abuse or threatened harm, the attorney may be harming his or her client's legal interests by using the forensic psychologist or psychiatrist to evaluate his or her client. This article will briefly review the development of mandated reporting laws for psychologists and psychiatrists and juxtapose those with the legal and ethical requirements of confidentiality for attorneys embodied in the attorney-client privilege and attorney work product privilege. The article will then discuss the California Court of Appeals case in Elijah W. v. Superior Court, where the court addressed the issue of whether retained mental health professionals must report suspected child abuse and threatened harm to others as required by law or if they do not need to report because they come under the umbrella of the attorney work product privilege. This California court ultimately concluded that retained psychologists and psychiatrists work under the attorney work product

  15. Examining Authentic Intellectual Work with a Historical Digital Documentary Inquiry Project in a Mandated State Testing Environment

    ERIC Educational Resources Information Center

    Swan, Kathy; Hofer, Mark; Swan, Gerry

    2011-01-01

    Three criteria for meaningful student learning--construction of knowledge, disciplined inquiry, and value beyond school--are assessed as authentic learning outcomes for an implementation of a digital documentary project in two fifth grade history classrooms where teachers' practices are constrained by a high-stakes testing climate. In all three…

  16. Authentic Pedagogy: Its Presence in Social Studies Classrooms and Relationship to Student Performance on State-Mandated Tests

    ERIC Educational Resources Information Center

    Saye, John

    2013-01-01

    Social studies researchers across a wide geographical area assessed the degree of authentic intellectual challenge present in a diverse sample of U.S. classrooms, investigated whether students from different social and academic contexts were more likely to encounter authentic pedagogy than others, and examined how the level of authentic pedagogy…

  17. Keep Kids in School: A Collaborative Community Effort to Increase Compliance with State-Mandated Health Requirements

    ERIC Educational Resources Information Center

    Rogers, Valerie; Salzeider, Christine; Holzum, Laura; Milbrandt, Tracy; Zahnd, Whitney; Puczynski, Mark

    2016-01-01

    Background: It is important that collaborative relationships exist in a community to improve access to needed services for children. Such partnerships foster preventive services, such as immunizations, and other services that protect the health and well-being of all children. Methods: A collaborative relationship in Illinois involving an academic…

  18. A Qualitative Meta-Analysis of the Diffusion of Mandated and Subsidized Technology: United States Energy Security and Independence

    ERIC Educational Resources Information Center

    Noah, Philip D., Jr.

    2013-01-01

    The purpose of this research project was to explore what the core factors are that play a role in the development of the smart-grid. This research study examined The Energy Independence and Security Act (EISA) of 2007 as it pertains to the smart-grid, the economic and security effects of the smart grid, and key factors for its success. The…

  19. Comparing State Mandated Test Scores for Students in Programs with and without Fine Arts in the Curriculum

    ERIC Educational Resources Information Center

    Garcia, Cynthia; Jones, Don; Isaacson, Carrie

    2015-01-01

    As a result of the No Child Left Behind Act (NCLB) of 2001, many school districts have reduced instructional time for the arts in order to focus on reading and mathematics. Accordingly, fine arts programs across the nation have become subject to budget cuts or elimination in order to meet federal accountability measures. Hit especially hard are…

  20. Comparing State Mandated Test Scores for Students in Programs with and without Fine Arts in the Curriculum

    ERIC Educational Resources Information Center

    Garcia, Cynthia M.

    2010-01-01

    As a result of the No Child Left Behind Act (NCLB) of 2001, many school districts have reduced instructional time for the arts in order to focus on reading and mathematics. Accordingly, fine arts programs across the nation have become subject to budget cuts or elimination in order to meet federal accountability measures. Hit especially hard are…

  1. Intended and Unintended Effects of State-Mandated High School Science and Mathematics Course Graduation Requirements on Educational Attainment

    PubMed Central

    Plunk, Andrew D.; Tate, William F.; Bierut, Laura J.; Grucza, Richard A.

    2014-01-01

    Mathematics and science course graduation requirement (CGR) increases in the 1980s and 1990s might have had both intended and unintended consequences. Using logistic regression with Census and American Community Survey (ACS) data (n = 2,892,444), we modeled CGR exposure on (a) high school dropout, (b) beginning college, and (c) obtaining any college degree. Possible between-groups differences were also assessed. We found that higher CGRs were associated with higher odds to drop out of high school, but results for the college-level outcomes varied by group. Some were less likely to enroll, whereas others who began college were more likely to obtain a degree. Increased high school dropout was consistent across the population, but some potential benefit was also observed, primarily for those reporting Hispanic ethnicity. PMID:25541563

  2. Intended and Unintended Effects of State-Mandated High School Science and Mathematics Course Graduation Requirements on Educational Attainment

    ERIC Educational Resources Information Center

    Plunk, Andrew D.; Tate, William F.; Bierut, Laura J.; Grucza, Richard A.

    2014-01-01

    Mathematics and science course graduation requirement (CGR) increases in the 1980s and 1990s might have had both intended and unintended consequences. Using logistic regression with Census and American Community Survey (ACS) data (n = 2,892,444), we modeled CGR exposure on (a) high school dropout, (b) beginning college, and (c) obtaining any…

  3. The Influence of a State Mandated Induction Assistance Program on the Socialization of a Beginning Physical Education Teacher

    ERIC Educational Resources Information Center

    Richards, K. Andrew; Templin, Thomas J.

    2011-01-01

    Using occupational socialization theory, this investigation describes the socialization of Janet, an induction phase physical education (PE) teacher. Special attention was given to the forms of induction assistance Janet was exposed to during her first two years at Liberty Middle School. Data were collected through seven interviews with Janet and…

  4. Optimal Mandates and The Welfare Cost of Asymmetric Information: Evidence from The U.K. Annuity Market*

    PubMed Central

    Einav, Liran; Finkelstein, Amy; Schrimpf, Paul

    2009-01-01

    Much of the extensive empirical literature on insurance markets has focused on whether adverse selection can be detected. Once detected, however, there has been little attempt to quantify its welfare cost, or to assess whether and what potential government interventions may reduce these costs. To do so, we develop a model of annuity contract choice and estimate it using data from the U.K. annuity market. The model allows for private information about mortality risk as well as heterogeneity in preferences over different contract options. We focus on the choice of length of guarantee among individuals who are required to buy annuities. The results suggest that asymmetric information along the guarantee margin reduces welfare relative to a first best symmetric information benchmark by about £127 million per year, or about 2 percent of annuitized wealth. We also find that by requiring that individuals choose the longest guarantee period allowed, mandates could achieve the first-best allocation. However, we estimate that other mandated guarantee lengths would have detrimental effects on welfare. Since determining the optimal mandate is empirically difficult, our findings suggest that achieving welfare gains through mandatory social insurance may be harder in practice than simple theory may suggest. PMID:20592943

  5. ESC [Empire State College] Student Library Use.

    ERIC Educational Resources Information Center

    Bradley, A. Paul, Jr.; Palola, Ernest G.

    This document reports results of a spring 1973 survey of library use by students at two of the four regional centers at Empire State College (ESC), the new, nontraditional college without a campus of the State University of New York. Because ESC is mandated not to duplicate the resources of the State, students must use existing public and academic…

  6. State Regulations for School Nursing Practice

    ERIC Educational Resources Information Center

    Praeger, Susan; Zimmerman, Barbara

    2009-01-01

    The purpose of this article is to present a state-by-state summary of rules and regulations governing school nursing practice in the United States. Official government and agency sites were reviewed to determine providers of services in schools, criteria for becoming a school nurse, protection of titling, mandates for school nursing, and the…

  7. I strong administrative buy-in, firm mandates can push flu vaccination rates up to more than 99% among health care workers.

    PubMed

    2014-11-01

    While flu vaccination rates are inching up among health care workers, there is still room for improvement. The Centers for Disease Control and Prevention reports that slightly more than 75% of health care workers received the flu vaccination during the 2013-14 season--an increase of roughly 3% over the 2012-13 season. However, some hospitals have been able to achieve vaccination rates in excess of 99%. The apparent key to these efforts is a firm mandate that all personnel receive a flu shot as a condition of employment. There is always pushback to such policies, but hospitals report that most personnel eventually come around. While flu vaccination rates are on the increase among health, care personnel, data from the Centers for Medicare and Medicaid Services (CMS) note that rates vary widely from state to state. For example, the vaccination rate for health care workers in New Jersey stood at just 62% last year. In contrast, more than 95% of health care workers in Maryland received the shot during the 2013-14 flu season. Both Loyola University Medical Center and Henry Ford Hospital have been able to boost flu vaccination rates among their health care workers to more than 99% with the implementation of policies that require flu shots as a condition of employment. Experts say successful flu vaccination campaigns require strong administration buy-in and physician leadership. PMID:25362750

  8. Proposed legislative change mandating retrospective release of identifying information: consultation with donors and Government response

    PubMed Central

    Hammarberg, Karin; Johnson, Louise; Bourne, Kate; Fisher, Jane; Kirkman, Maggie

    2014-01-01

    STUDY QUESTION How do gamete donors who presumed they could remain anonymous respond to proposed legislation to retrospectively remove anonymity? SUMMARY ANSWER A little more than half of the donors opposed the recommendation to introduce legislation to remove donor anonymity with retrospective effect. WHAT IS KNOWN ALREADY An increasing proportion of parents disclose their origins to their donor-conceived children and growing numbers of donor-conceived adults are aware of how they were conceived. Research indicates that access to information about the donor is important to donor-conceived people. However, worldwide most donor-conceived people are unable to find any identifying information about the donor because of the practice of anonymous gamete donation. STUDY DESIGN, SIZE, DURATION This study adopted a qualitative research model using semi-structured interviews with gamete donors that included open questions. Interviews with 42 volunteers were conducted between December 2012 and February 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS Before 1998 gamete donors in Victoria, Australia, were able to remain anonymous. Pre-1998 donors were invited through an advertising campaign to be interviewed about their views on a recommendation that legislation mandating retrospective release of identifying information be introduced. MAIN RESULTS AND THE ROLE OF CHANCE Donors were almost evenly split between those who supported and those who rejected the recommendation to introduce legislation to remove donor anonymity with retrospective effect. About half of the donors who rejected the recommendation suggested the compromise of persuading donors voluntarily to release information (whether identifying or non-identifying) to donor-conceived people. These donors were themselves willing to supply information to their donor offspring. The findings of this study informed the Victorian Government's response to the proposed legislative change. While acknowledging donor

  9. Project IEP: Albama State Report.

    ERIC Educational Resources Information Center

    Penney, Catherine

    The document reports the Alabama component of Project IEP (individualized education program), a project designed to identify and clarify perceptions related to roles in the IEP process as mandated by P.L. 94-142, the Education for All Handicapped Children Act. It is explained that under Project IEP approximately 200 persons (including state and…

  10. Project IEP: Wisconsin State Report.

    ERIC Educational Resources Information Center

    Norton, Barbara Dwyer

    The document reports the Wisconsin component of Project IEP (individualized education program), a project designed to identify and clarify perceptions related to roles in the IEP process as mandated by P.L. 94-142, the Education for All Handicapped Children Act. It is explained that under Project IEP approximately 200 persons (including state and…

  11. Project IEP: Washington State Report.

    ERIC Educational Resources Information Center

    Lewis, Linda M.

    The document reports the Washington component of Project IEP (individualized education program), a project designed to identify and clarify perceptions related to roles in the IEP process as mandated by P.L. 94-142, the Education for All Handicapped Children Act. It is explained that under Project IEP approximately 200 persons (including state and…

  12. Florida's Mandated Educational Leadership Program Redesign: The William Cecil Golden Touch

    ERIC Educational Resources Information Center

    Mountford, Meredith; Acker-Hocevar, Michele A.

    2013-01-01

    In 2007, educational leadership programs in Florida were notified by Florida's Department of Education of a law requiring all programs to align with new legislation, State Rule 6A-5.081. Previously, most state-approved preparation programs were based on Florida's Leadership Preparation Standards, a version of the 1996 Interstate School…

  13. Impact of a Private Health Insurance Mandate on Public Sector Autism Service Use in Pennsylvania

    ERIC Educational Resources Information Center

    Stein, Bradley D.; Sorbero, Mark J.; Goswami, Upasna; Schuster, James; Leslie, Douglas L.

    2012-01-01

    Objective: Many states have implemented regulations (commonly referred to as waivers) to increase access to publicly insured services for autism spectrum disorders (ASD). In recent years, several states have passed legislation requiring improved coverage for ASD services by private insurers. This study examines the impact of such legislation on…

  14. State Directors of Special Education Transition Programs: State Definitions, and Real and Ideal Teacher Competencies.

    ERIC Educational Resources Information Center

    Beard, John; And Others

    This study surveys states' mandates, definitions, and components of transition programs that assist disabled students in successfully moving to the community environment. Among the 60 state-level directors of special education surveyed, 34 state and 4 territorial directors responded to the questionnaire comprised of 8 questions, and nominated 230…

  15. Mandated College Students’ Response to Sequentially-Administered Alcohol Interventions in a Randomized Clinical Trial Using Stepped Care

    PubMed Central

    Borsari, Brian; Magill, Molly; Mastroleo, Nadine R.; Hustad, John T.P.; Tevyaw, Tracy O’Leary; Barnett, Nancy P.; Kahler, Christopher W.; Eaton, Erica; Monti, Peter M.

    2015-01-01

    Objective Students referred to school administration for alcohol policies violations currently receive a wide variety of interventions. This study examined predictors of response to two interventions delivered to mandated college students (N = 598) using a stepped care approach incorporating a peer-delivered 15-minute BA session (BA; Step 1) and a 60–90 minute brief motivational intervention delivered by trained interventionists (BMI; Step 2). Method Analyses were completed in two stages. First, three types of variables (screening variables, alcohol-related cognitions, mandated student profile) were examined in a logistic regression model as putative predictors of lower-risk drinking (defined as 3 or fewer heavy episodic drinking [HED] episodes and/or 4 or fewer alcohol-related consequences in the past month) six weeks following the BA session. Second, we used generalized estimating equations to examine putative moderators of BMI effects on HED and peak blood alcohol content (pBAC) compared to assessment-only control (AO) over the 3, 6, and 9 month follow-ups. Results Participants reporting lower scores on the Alcohol Use Disorders Identification Test (AUDIT), more benefits to changing alcohol use, and those who fit the ‘Bad Incident’ profile at baseline were more likely to report lower risk drinking 6 weeks after the BA session. Moderation analyses revealed that ‘Bad Incident’ students who received the BMI reported more HED at 9-month follow up than those who received AO. Conclusion Current alcohol use as well as personal reaction to the referral event may have clinical utility in identifying which mandated students benefit from treatments of varying content and intensity. PMID:26460571

  16. Aligning State Standards and the Expanded Core Curriculum: Balancing the Impact of the No Child Left Behind Act

    ERIC Educational Resources Information Center

    Lohmeier, Keri L.

    2009-01-01

    How do professionals address accountability mandates that are derived from the No Child Left Behind Act and the overall educational needs of students who are visually impaired during the school day? Meeting state and federal mandates while maintaining the individuality of educational programs is challenging for all educators. Teachers of students…

  17. The Trojan Horse of Educational Reform: A Look at One State's Experience and the Perceptions of Selected School Administrators.

    ERIC Educational Resources Information Center

    Chance, Edward W.

    1993-01-01

    A survey addressed the financial impact of state-mandated reforms on 40 rural Oklahoma school districts. A majority of school administrators surveyed reported that they did not receive adequate dollars to meet curriculum standard mandates and the minimum teacher salary schedule. Long-term results may include consolidation. (LP)

  18. The dynamic model on the impact of biodiesel blend mandate (B5) on Malaysian palm oil domestic demand: A preliminary finding

    NASA Astrophysics Data System (ADS)

    Abidin, Norhaslinda Zainal; Applanaidu, Shri-Dewi; Sapiri, Hasimah

    2014-12-01

    Over the last ten years, world biofuels production has increased dramatically. The biodiesel demand is driven by the increases in fossil fuel prices, government policy mandates, income from gross domestic product and population growth. In the European Union, biofuel consumption is mostly driven by blending mandates in both France and Germany. In the case of Malaysia, biodiesel has started to be exported since 2006. The B5 of 5% blend of palm oil based biodiesel into diesel in all government vehicles was implemented in February 2009 and it is expected to be implemented nationwide in the nearest time. How will the blend mandate will project growth in the domestic demand of palm oil in Malaysia? To analyze this issue, a system dynamics model was constructed to evaluate the impact of blend mandate implementation on the palm oil domestic demand influence. The base run of simulation analysis indicates that the trend of domestic demand will increase until 2030 in parallel with the implementation of 5 percent of biodiesel mandate. Finally, this study depicts that system dynamics is a useful tool to gain insight and to experiment with the impact of changes in blend mandate implementation on the future growth of Malaysian palm oil domestic demand sector.

  19. State Plans for Implementing Programs of Study

    ERIC Educational Resources Information Center

    Lewis, Morgan V.; Overman, Laura

    2008-01-01

    This article examines how the states plan to implement the Programs of Study (POS) that were mandated by the 2006 reauthorization of the federal legislation for career and technical education. A coding system was developed for summarizing the methods described in the plans of all 50 states, the District of Columbia, Guam, and the Virgin Islands.…

  20. States as Change Agents under ESSA

    ERIC Educational Resources Information Center

    Weiss, Joanne; McGuinn, Patrick

    2016-01-01

    Under the Every Student Succeeds Act (ESSA), federal education mandates will be decreasing, which means states will have more flexibility and authority than they've had in decades. State education agency (SEA) leaders are confronting great change and great opportunity as many agencies move away from a focus on compliance with federal regulations,…

  1. Washington State Board of Education Strategic Plan, 2010-2011

    ERIC Educational Resources Information Center

    Washington State Board of Education, 2011

    2011-01-01

    In 2005, the Washington State Legislature significantly changed the role of the State Board of Education (SBE). While the Board retains some administrative duties, SBE is now mandated to play a broad leadership role in strategic oversight and policy for K-12 education in the state. This paper presents the strategic plan of Washington State Board…

  2. Puppets and Puppeteers: External Mandates and the Instructional Practice of Two First-Year Teachers

    ERIC Educational Resources Information Center

    Bengtson, Ed; Connors, Sean P.

    2014-01-01

    This longitudinal study examined how the approach leaders in two schools took to implementing the Common Core State Standards shaped the way that two first-year teachers constructed meaning related to being a teacher. Instructional leadership constructs and threat rigidity theory were used to analyze qualitative data gathered over a nine-month…

  3. Public Values in a Divided World: A Mandate for Higher Education.

    ERIC Educational Resources Information Center

    Joseph, James A.

    2002-01-01

    Discusses changes in ethics' role in public life: (1) many people who live morally are insisting that institutions do the same; (2) while ethics have been used to humanize power, ethics now are power; and (3) private values that provided moral strength at the dawning of nation states must be transformed into public values for an interdependent…

  4. The Administrative Aspects of P.L. 94-142: Dealing with Federal Mandates and Compliances.

    ERIC Educational Resources Information Center

    Abbruzzese, John A., Jr.

    Although Pennsylvania has long made programming for all handicapped children mandatory, the passage of P.L. 94-142 has necessitated some changes even in this state. The major hurdle in the implementation of such a law is confusion and misinterpretation. Educators fear that the handicapped may be dumped into regular classes in an arbitrary manner.…

  5. Responding to Teacher Quality and Accountability Mandates: The Perspective of School Administrators and Classroom Teachers

    ERIC Educational Resources Information Center

    Roellke, Christopher; Rice, Jennifer King

    2008-01-01

    In this article, we examine how the federal, state, and district policy environments affect the decisions and work of principals and teachers. Specifically, we examine principal and teacher perceptions of policies and practices focused on: (1) increasing the overall supply of qualified teachers; (2) recruiting qualified teachers; (3) distributing…

  6. From Policy to Practice: Parent Perceptions of the 2010 Federal School Lunch Mandate

    ERIC Educational Resources Information Center

    Golembiewski, Elizabeth H.; Askelson, Natoshia M.; Elchert, Daniel M.; Leicht, Erika A.; Scheidel, Carrie A.; Delger, Patti J.

    2015-01-01

    Purpose/Objectives: The purpose of this study was to investigate parent awareness and perceptions of changes to the National School Lunch Program (NSLP) implemented as a result of the Healthy, Hunger-Free Kids Act (HHKA) of 2010. Methods: An online survey of parents of school age (K-12) children in a Midwestern state was conducted (n = 2,189). The…

  7. From Coordinating Board to Campus: Implementation of a Policy Mandate on Remedial Education.

    ERIC Educational Resources Information Center

    Mills, Michael

    1998-01-01

    A study examined how three Oklahoma institutions (Langston University, Tulsa Community College, University of Central Oklahoma) implemented a specific remedial education policy enacted by the state coordinating board for certain students. The analysis demonstrates how institutional actors ascribed sense to the goals, assumptions, and expectations…

  8. What Legally Constitutes an Adequate Public Education? A Review of Constitutional, Legislative, and Judicial Mandates.

    ERIC Educational Resources Information Center

    McCarthy, Martha M.; Deignan, Paul T.

    While the law governing the definition of educational adequacy is still evolving, partial definitions can be gleaned from various state and federal laws and regulations prescribing standards for schools and from judicial interpretations of constitutional and statutory provisions. This document presents the results of such an analysis. After…

  9. Internal Evaluation in American Public School Districts: The Importance of Externally Driven Accountability Mandates

    ERIC Educational Resources Information Center

    King, Jean A.; Rohmer-Hirt, Johnna A.

    2011-01-01

    From the 1980s to the present, educational accountability in the United States has grown dramatically. Such accountability in U.S. school districts, although driven primarily by external demands, has internal manifestations as well. The chapter traces the historical development of internal evaluation in American school districts, then highlights…

  10. Education Reform: Federal Initiatives and National Mandates, 1963-1993. Occasional Paper 1993-3.

    ERIC Educational Resources Information Center

    Levitan, Sar A.; Gallo, Frank

    The federal government initiated educational reform measures in the United States long before the subject became a matter of national concern. In recent decades, reform has focused on helping children whose special needs were neglected by the school system. Evidence shows that these efforts have improved services to neglected groups, but without…

  11. To Adapt or Subscribe: Teachers' Informal Collaboration and View of Mandated Curricula

    ERIC Educational Resources Information Center

    Stevenson, Heidi J.

    2008-01-01

    California public schools serve a highly diverse student population, including: 65% minorities, 24.9% English Language Learners, 10.6% disabled, and 19% in poverty. In the face of this diversity, all teachers are expected to use the Curriculum Frameworks of the California State Board of Education as a "blueprint for implementing the content…

  12. 77 FR 59629 - Statutorily Mandated Designation of Difficult Development Areas for 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ...This notice designates ``Difficult Development Areas'' (DDAs) for purposes of the Low-Income Housing Tax Credit (LIHTC) under Section 42 of the Internal Revenue Code of 1986 (IRC). The United States Department of Housing and Urban Development (HUD) makes DDA designations annually. In addition to announcing the 2013 DDA designations, this notice responds to public comment received in response......

  13. Mandated Program Review and Program Discontinuance: Qualitative vs. Quantitative Standards. ASHE 1987 Annual Meeting Paper.

    ERIC Educational Resources Information Center

    Hammond, Martine F.; And Others

    Internal and external pressures that affect college program discontinuance schemes were investigated, based on minutes of the Kansas State Board of Regents and three other government-related groups/subgroups. During 1972-1986, a total of 206 programs were merged or discontinued. In 1972 a policy was enacted whereby masters programs that had…

  14. Constitutional Mandate for Free and Compulsory Education: New Light on the Intention of the "Founding Fathers"

    ERIC Educational Resources Information Center

    Juneja, Nalini

    2015-01-01

    The original constitutional provision for free and compulsory education, granted under Article 45 stated that it was to be available for "all children until they complete the age of fourteen years", but it did not specify the lower age limit nor the stage of education (whether elementary or primary) that would be free and compulsory.…

  15. The Success and Failure of One Mandated Reform for Young Children

    ERIC Educational Resources Information Center

    McIntyre, Ellen; Kyle, Diane W.

    2006-01-01

    This article illustrates the implementation of a school reform policy for educating young children in one south eastern state in the US, a reform known as the non-graded primary program. The reform is examined through the lens of Sabatier and Mazmanian's [(1981). "The implementation of public policy: A framework for analysis." In D. A. Mazmanian,…

  16. Mandated Curriculum Change and a Science Department: A Superficial Language Convergence?

    ERIC Educational Resources Information Center

    Melville, Wayne

    2008-01-01

    This article investigates the introduction of a systemic curriculum change, the Essential Learnings curriculum framework, in the Australian state of Tasmania. Using Gee's [(2003). Language in the science classroom: Academic social languages as the heart of school-based literacy. In: R. Yerrick, & W.-M. Roth (Eds.), "Establishing scientific…

  17. Making the Case for Primary Care and Mandated Suicide Prevention Education

    ERIC Educational Resources Information Center

    Stuber, Jennifer; Quinnett, Paul

    2013-01-01

    During its 2012 legislative session, Washington State passed ESHB 2366, otherwise known as the Matt Adler Suicide Assessment, Treatment, and Management Act of 2012. ESHB 2366 is a significant legislative achievement as it is the first law in the country to require certain health professionals to obtain continuing education in the assessment,…

  18. Conflicted Identification in the Sex Education Classroom: Balancing Professional Values With Organizational Mandates.

    PubMed

    Williams, Elizabeth A; Jensen, Robin E

    2016-09-01

    Despite enormous resources spent on sex education, the United States faces an epidemic of unplanned pregnancy and sexually transmitted infections among young people. Little research has examined the role sex educators play in alleviating or exacerbating this problem. In this study, we interviewed 50 sex educators employed by public schools throughout a Midwestern, U.S. state about their experiences in the sex education classroom. Twenty-two interviewees communicated feelings of conflicted identification and provided examples of the ways in which they experienced this subjectivity in the context of their employment. We find these interviews shed light on the as-yet-understudied communicative experience of conflicted identification by delineating key sources of such conflict and discursive strategies used in its negotiation. Our results suggest that those who experience conflicted identification and who have a sense of multiple or nested identifications within their overarching professional identity may be safeguarded to some extent from eventual organizational disidentification. PMID:26290543

  19. Mandating responsible flagging practices as a strategy for reducing the risk of coastal oil spills.

    PubMed

    Miller, Dana D; Hotte, Ngaio; Sumaila, U Rashid

    2014-04-15

    As human civilization is becoming more aware of the negative impact our actions can inflict upon the natural world, the intensification of fossil fuel extraction and industrial development is being met with increasing opposition. In Western Canada, proposals that would increase the volume of petroleum transported by pipelines and by tankers through the coastal waters of British Columbia have engaged the province in debate. To ease public concern on the risk of a coastal oil spill, there are additional commitments that involved parties could make. There is evidence to show that the practice of registering vessels under foreign flags of states that have exhibited failure in compliance with international obligations is more common amongst petroleum tankers that have been involved in large-scale oil spills. To prove that they are committed to reducing the risk of oil spills, businesses need to stop registering their vessels under flags of foreign, non-compliant states. PMID:24467855

  20. Collaborations between the State and Local Colleges: Sleeping with the Enemy?

    ERIC Educational Resources Information Center

    Brand, Elizabeth Cox

    2014-01-01

    This chapter describes the characteristics of successful partnerships between a state-level department and local community colleges. Particular focus is paid to the lack of mandated collaboration between the entities and the elements necessary for motivation and sustainability.

  1. Biosafety, biosecurity and internationally mandated regulatory regimes: compliance mechanisms for education and global health security

    PubMed Central

    Sture, Judi; Whitby, Simon; Perkins, Dana

    2015-01-01

    This paper highlights the biosafety and biosecurity training obligations that three international regulatory regimes place upon states parties. The duty to report upon the existence of such provisions as evidence of compliance is discussed in relation to each regime. We argue that such mechanisms can be regarded as building blocks for the development and delivery of complementary biosafety and biosecurity teaching and training materials. We show that such building blocks represent foundations upon which life and associated scientists – through greater awareness of biosecurity concerns – can better fulfil their responsibilities to guard their work from misuse in the future. PMID:24494580

  2. Mandate a Man to Fish?: Technological advance in cooling systems at U.S. thermal electric plants

    NASA Astrophysics Data System (ADS)

    Peredo-Alvarez, Victor M.; Bellas, Allen S.; Trainor-Guitton, Whitney J.; Lange, Ian

    2016-02-01

    Steam-based electrical generating plants use large quantities of water for cooling. The potential environmental impacts of water cooling systems have resulted in their inclusion in the Clean Water Act's (CWA) Sections 316(a), related to thermal discharges and 316(b), related to cooling water intake. The CWA mandates a technological standard for water cooling systems. This analysis examines how the performance-adjusted rates of thermal emissions and water withdrawals for cooling units have changed over their vintage and how these rates of change were impacted by imposition of the CWA. Results show that the rate of progress increased for cooling systems installed after the CWA whilethere was no progress previous to it.

  3. Enhancing user acceptance of mandated mobile health information systems: the ePOC (electronic point-of-care project) experience.

    PubMed

    Burgess, Lois; Sargent, Jason

    2007-01-01

    From a clinical perspective, the use of mobile technologies, such as Personal Digital Assistants (PDAs) within hospital environments is not new. A paradigm shift however is underway towards the acceptance and utility of these systems within mobile-based healthcare environments. Introducing new technologies and associated work practices has intrinsic risks which must be addressed. This paper contends that intervening to address user concerns as they arise throughout the system development lifecycle will lead to greater levels of user acceptance, while ultimately enhancing the deliverability of a system that provides a best fit with end user needs. It is envisaged this research will lead to the development of a formalised user acceptance framework based on an agile approach to user acceptance measurement. The results of an ongoing study of user perceptions towards a mandated electronic point-of-care information system in the Northern Illawarra Ambulatory Care Team (TACT) are presented. PMID:17911883

  4. Six Stories about Six States: Programs of Study

    ERIC Educational Resources Information Center

    Shumer, Rob; Digby, Cynthia

    2011-01-01

    The purpose of this investigation is to tell the story of how six states are developing Programs of Study (POS) as mandated by the Perkins IV federal legislation. The authors' effort focuses on how states' technical assistance systems evolved and what successes and challenges existed for states developing POS. There was no intent to compare one…

  5. Implementing Accelerated Schools: Issues at the State Level.

    ERIC Educational Resources Information Center

    LeTendre, Brenda G.

    Despite the blizzard of reform activity since 1983, neither state legislation nor state education department mandates have diminished the failure rates of at-risk youngsters. One-third of all elementary students are at risk of failing academically. This paper reviews past state department of education reform efforts and suggests innovative ways…

  6. AZ State Profile. Arizona: Arizona's Instrument to Measure Standards (AIMS)

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper provides information about the Arizona's Instrument to Measure Standards (AIMS). The purpose of the test is to determine prospective high school graduates' mastery of the state curriculum and to meet a state mandate. [For the main report, "State High School Tests: Exit Exams and Other Assessments", see ED514155.

  7. An Analysis of Bullying Legislation among the Various States

    ERIC Educational Resources Information Center

    Hallford, Abby Jane Swanson

    2009-01-01

    Scope and method of study. The purpose of this study is to understand the existing state legislation concerning bullying in schools to determine whether the development, structure, and content of these state mandates parallel any change in reported incidents of bullying by public schools in each of those states. This is a descriptive and…

  8. Blair v. Washington State University: Making State ERA'a a Potent Remedy for Sex Discrimination in Athletics.

    ERIC Educational Resources Information Center

    Graff, Doralice McEuen; And Others

    1988-01-01

    The case of Blair vs. Washington State University revives the state equal rights amendment as a feasible and powerful cause of action against sex-based discrimination, in college athletics and beyond. Washington's amendment mandated equality in funding, facilities, treatment, and opportunities for Washington State University's women's…

  9. Midwest U.S. landscape change to 2020 driven by biofuel mandates.

    PubMed

    Mehaffey, Megan; Smith, Elizabeth; Van Remortel, Rick

    2012-01-01

    Meeting future biofuel targets set by the 2007 Energy Independence and Security Act (EISA) will require a substantial increase in production of corn. The Midwest, which has the highest overall crop production capacity, is likely to bear the brunt of the biofuel-driven changes. In this paper, we set forth a method for developing a possible future landscape and evaluate changes in practices and production between base year (BY) 2001 and biofuel target (BT) 2020. In our BT 2020 Midwest landscape, a total of 25 million acres (1 acre = 0.40 ha) of farmland was converted from rotational cropping to continuous corn. Several states across the Midwest had watersheds where continuous corn planting increased by more than 50%. The output from the Center for Agriculture and Rural Development (CARD) econometric model predicted that corn grain production would double. In our study we were able to get within 2% of this expected corn production. The greatest increases in corn production were in the Corn Belt as a result of conversion to continuous corn planting. In addition to changes to cropping practices as a result of biofuel initiatives we also found that urban growth would result in a loss of over 7 million acres of productive farmland by 2020. We demonstrate a method which successfully combines economic model output with gridded land cover data to create a spatially explicit detailed classification of the landscape across the Midwest. Understanding where changes are likely to take place on the landscape will enable the evaluation of trade-offs between economic benefits and ecosystem services allowing proactive conservation and sustainable production for human well-being into the future. PMID:22471072

  10. Outcomes of civil protective orders: results from one state.

    PubMed

    Diviney, Charles L; Parekh, Asha; Olson, Lenora M

    2009-07-01

    This study compares final sentencing decisions ordered by judges to federal and state sentencing guidelines for protective order violations. The authors reviewed violations that were pled before the largest district court in Utah and found that in the majority of cases, defendants were not sentenced in accordance with federal and state guidelines. Although state guidelines mandate defendants who violate a protective order to attend a batterer intervention program, less than one fourth of defendants were sentenced to attend such programs. Fewer than half of the defendants were arrested and incarcerated, as opposed to the 100% mandated by state sentencing guidelines. Federal guidelines mandate that all defendants be ordered to surrender firearms, but only six defendants were given that order. This study shows that the judicial system could be more aggressive in improving the safety of victims of intimate partner violence by using the full extent of the sentencing guidelines. PMID:18701748

  11. State of Washington Strategic Information Technology Plan.

    ERIC Educational Resources Information Center

    Washington State Dept. of Information Services, Olympia. Policy and Regulation Div.

    The Strategic Information Technology Plan of Washington is introduced and explained. The plan is mandated by state law to create a new framework for communication and collaboration to bring together agency technology planning with the achievement of statewide information technology goals and strategies. It provides a point of reference for the…

  12. State Energy Efficiency Program Evaluation Inventory

    EIA Publications

    2013-01-01

    The focus of this inventory, some of which has been placed into a searchable spreadsheet, is to support the National Energy Modeling System (NEMS) and to research cost information in state-mandated energy efficiency program evaluations – e.g., for use in updating analytic and modeling assumptions used by the U.S. Energy Information Administration (EIA).

  13. Florida: State of the Foreign Language Arts.

    ERIC Educational Resources Information Center

    Valdes, Gabriel M.

    In Florida, foreign language teaching has consistently followed national trends. Currently, there is a renaissance in language study. Enrollment has increased dramatically at all educational levels, due to a mandated state university system entrance requirement and two programs, the Florida Academic Scholars Program and Foreign Languages in the…

  14. State Teacher Evaluation and Teacher Education

    ERIC Educational Resources Information Center

    Marchant, Gregory J.; David, Kristine A.; Rodgers, Deborah; German, Rachel L.

    2015-01-01

    Current accountability trends suggest an increasing role in state mandates regarding teacher evaluation. With various evaluation models and components serving as the basis for quality teaching, teacher education programs need to recognize the role teacher evaluation plays and incorporate aspects where appropriate. This article makes that case and…

  15. Athletes' Perceptions of National Collegiate Athletic Association--Mandated Sickle Cell Trait Screening: Insight for Academic Institutions and College Health Professionals

    ERIC Educational Resources Information Center

    Lawrence, Raymona H.; Shah, Gulzar H.

    2014-01-01

    Objective: The study objective was to explore athletes' perspectives of National Collegiate Athletic Association (NCAA)--mandated sickle cell trait (SCT)--screening policy by examining race- and gender-related differences in athletes' perceptions regarding risk of having SCT and concern about loss of playing time. Participants:…

  16. Flaws and Failings: A Preliminary Look at the Problems Already Encountered in the Implementation of the District of Columbia's New Federally Mandated School Voucher Program. Special Report

    ERIC Educational Resources Information Center

    People For the American Way, 2005

    2005-01-01

    This special report discusses the new federally mandated school voucher program in the District of Columbia, which is the first federally-funded voucher program in the country. The voucher program is being run by the U.S. Department of Education ("DOE") in cooperation with the Mayor of the District of Columbia, and administered by a private…

  17. Descriptive Norms and Expectancies as Mediators of a Brief Motivational Intervention for Mandated College Students Receiving Stepped Care for Alcohol Use

    PubMed Central

    Yurasek, Ali M.; Borsari, Brian; Magill, Molly; Mastroleo, Nadine R.; Hustad, John T.P.; Tevyaw, Tracy O'Leary; Barnett, Nancy P.; Kahler, Christopher W.; Monti, Peter M.

    2015-01-01

    Background and Aims Stepped care approaches for mandated college students provide individual Brief Motivational Interventions (BMI) only for individuals who do not respond to an initial, low-intensity level of treatment such as Brief Advice (BA). However, how BMIs facilitate change in this higher-risk group of mandated students remains unclear. Perceived descriptive norms and alcohol-related expectancies are the most commonly examined mediators of BMI efficacy, but have yet to be examined in the context of stepped care. Methods Participants were mandated college students (N = 598) participating in a stepped care trial in which mandated students first received BA. Those who reported continued risky drinking 6 weeks following a BA session were randomized to either a single-session BMI (N=163) or an Assessment-only comparison condition (AO; N = 165). BMI participants reduced alcohol-related problems at the 9 month follow up significantly more than AO participants. Multiple mediation analyses using bootstrapping techniques examined whether perceived descriptive norms and alcohol-related expectancies mediated the observed outcomes. Results Reductions in perceptions of average student drinking (B = -.24; CI = -.61 to -.04) and negative expectancies (B = -.13; CI = -.38 to -.01) mediated the BMI effects. Furthermore, perceived average student norms were reduced after the BMI to levels approximating those of students who had exhibited lower risk drinking following the BA session. Conclusions Findings highlight the utility of addressing perceived norms and expectancies in BMIs, especially for students who have not responded to less intensive prevention efforts. PMID:26098125

  18. Special Report on the Impact of the Change in the Definition of Developmental Disabilities (Mandated in P.L. 95-602, Sec. 502(b) (2)).

    ERIC Educational Resources Information Center

    Office of Human Development Services (DHHS), Washington, DC.

    The report analyzes the impact of the change from a categorical definition of developmental disabilities to one which emphasizes functional limitations and the accompanying need for services as mandated by the 1978 Developmental Disabilities Assistance and Bill of Rights Act (P.L. 95-602, Section 502). Part I is an introduction with sections on…

  19. The Impact of a Universal Class-Size Reduction Policy: Evidence from Florida's Statewide Mandate. Program on Education Policy and Governance Working Papers Series. PEPG 10-03

    ERIC Educational Resources Information Center

    Chingos, Matthew M.

    2010-01-01

    Class-size reduction (CSR) mandates presuppose that resources provided to reduce class size will have a larger impact on student outcomes than resources that districts can spend as they see fit. I estimate the impact of Florida's statewide CSR policy by comparing the deviations from prior achievement trends in districts that were required to…

  20. Examining Mandated Testing, Teachers' Milieu, "and" Teachers' Knowledge and Beliefs: Gaining a Fuller Understanding of the Web of Influence on Teachers' Classroom Practices

    ERIC Educational Resources Information Center

    Neumann, Jacob W.

    2016-01-01

    Background: Much research has been done on the factors that influence teachers' work. Yet, the nature and scope of those factors, and their impact on teachers, remain unclear. Indeed, different literature bases on teachers' work present different and often contradictory conclusions. For example, some researchers claim that mandated accountability…