Science.gov

Sample records for state payer mandates

  1. State Curriculum Mandates and Student Knowledge of Personal Finance.

    ERIC Educational Resources Information Center

    Tennyson, Sharon; Nguyen, Chau

    2001-01-01

    A financial literacy test was administered to 1,643 high school students in 31 states. State mandates for generic consumer education were not associated with higher scores. Students in states requiring specific personal finance coursework scored significantly higher than those in generic-mandate or no-mandate states. (Contains 23 references.) (SK)

  2. Effects of state contraceptive insurance mandates.

    PubMed

    Dills, Angela K; Grecu, Anca M

    2017-02-01

    Using U.S. Natality data for 1996 through 2009 and an event analysis specification, we investigate the dynamics of the effects of state insurance contraceptive mandates on births and measures of parental investment: prenatal visits, non-marital childbearing, and risky behaviors during pregnancy. We analyze outcomes separately by age, race, and ethnicity. Among young Hispanic women, we find a 4% decline in the birth rate. There is evidence of a decrease in births to single mothers, consistent with increased wantedness. We also find evidence of selection into motherhood, which could explain the lack of a significant effect on birth outcomes.

  3. 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…

  4. Assessing early implementation of state autism insurance mandates

    PubMed Central

    Baller, Julia Berlin; Barry, Colleen L; Shea, Kathleen; Walker, Megan M; Ouellette, Rachel; Mandell, David S

    2016-01-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined five states’ experiences implementing autism insurance mandates. Semi-structured, key-informant interviews were conducted with 17 participants representing consumer advocacy organizations, provider organizations, and health insurance companies. Overall, participants thought that the mandates substantially affected the delivery of autism services. While access to autism treatment services has increased as a result of implementation of state mandates, states have struggled to keep up with the demand for services. Participants provided specific information about barriers and facilitators to meeting this demand. Understanding of key informants’ perceptions about states’ experiences implementing autism insurance mandates is useful for other states considering adopting or expanding mandates or other policies to expand access to autism treatment services. PMID:26614401

  5. Assessing Early Implementation of State Autism Insurance Mandates

    ERIC Educational Resources Information Center

    Baller, Julia Berlin; Barry, Colleen L.; Shea, Kathleen; Walker, Megan M.; Ouellette, Rachel; Mandell, David S.

    2016-01-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined…

  6. 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…

  7. 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.

  8. State-Mandated Principal Evaluation: A Report on Current Practice.

    ERIC Educational Resources Information Center

    Peters, Stephen; Bagenstos, Naida Tushnet

    State-mandated practices for evaluation of principals are described. Most such programs draw on three bodies of literature concerning management and organizational theory, personnel evaluation, and effective principalship. In most evaluations, four concerns are constant: (1) supervision and staff development; (2) school and community relations;…

  9. New evidence on the effects of state mental health mandates.

    PubMed

    Busch, Susan H; Barry, Colleen L

    2008-01-01

    State mental health parity laws improve equity in private insurance coverage for mental and physical health services, but prior research shows no effect on service use. We study whether state parity differentially affects individuals by employer size since large firms are often exempt from state health mandates due to the Employee Retirement Income Security Act. We also examine whether state parity laws differentially affect use among individuals with low incomes or in poor mental health. We find that individuals in smaller firms are more likely to use services post-parity implementation and that this effect is concentrated among low-income individuals.

  10. 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.

  11. Influence of Injury Characteristics and Payer Status on Burn Treatment Location in Washington State

    PubMed Central

    Klein, Matthew B.; Mack, Christopher D.; Kramer, C. Bradley; Heimbach, David M.; Gibran, Nicole S.; Rivara, Frederick P.

    2011-01-01

    The provision of optimal burn care is a resource-intensive endeavor. The American Burn Association has developed criteria to help guide the decision to refer a patient to a burn center for definitive injury care. The purpose of this study was to compare the patient and injury characteristics of patients admitted to the single verified burn center in Washington State with those treated at other facilities in the state. We performed a retrospective review of all patients admitted to a hospital with a burn injury in Washington State from 1987 to 2005 using the state’s discharge database (Comprehensive Hospital Abstract Reporting System). Patient and injury factors of patients admitted to the state’s single verified burn center or at other hospitals were compared. Multivariate poisson regression was used to calculate the relative risk of injury and patient factors that were significantly associated with admission to the verified burn center. From 1987 to 2005, a total of 16,531 patients were admitted to a Washington State hospital after burn injury. Of these patients, 8624 (52.2%) were treated definitively at the University of Washington Burn Center. Patients treated at this verified center had larger overall burn size (7.4% vs 4.5% TBSA, P < .001), higher percent full-thickness burn (4.3% vs 1.2%, P < .001), and higher rates of inhalation injury (2.3% vs 1.5%, P = .005). Uninsured status (relative risk = 1.46, 95% confidence interval = 1.4–1.5) was also significantly associated with treatment at the verified burn center. Injury severity and payer status were both found to be independent predictors of treatment at the single verified burn center in Washington. PMID:18388579

  12. Myths and memes about single-payer health insurance in the United States: a rebuttal to conservative claims.

    PubMed

    Geyman, John P

    2005-01-01

    Recent years have seen the rapid growth of private think tanks within the neoconservative movement that conduct "policy research" biased to their own agenda. This article provides an evidence-based rebuttal to a 2002 report by one such think tank, the Dallas-based National Center for Policy Analysis (NCPA), which was intended to discredit 20 alleged myths about single-payer national health insurance as a policy option for the United States. Eleven "myths" are rebutted under eight categories: access, cost containment, quality, efficiency, single-payer as solution, control of drug prices, ability to compete abroad (the "business case"), and public support for a single-payer system. Six memes (self-replicating ideas that are promulgated without regard to their merits) are identified in the NCPA report. Myths and memes should have no place in the national debate now underway over the future of a failing health care system, and need to be recognized as such and countered by experience and unbiased evidence.

  13. State Mandates and General Education: One Campus Responds to Challenges and Opportunities

    ERIC Educational Resources Information Center

    Alexander, Ross; Blakefield, Mary; Frank, Katherine; Pomper, Markus

    2016-01-01

    This study highlights the efforts of Indiana University East to make substantive changes to its general education program, resulting primarily from state mandates and legislation, on an extremely aggressive timeline. While fraught with challenges, these legislative mandates also presented opportunities for the institution to make necessary and…

  14. US state variation in autism insurance mandates: Balancing access and fairness

    PubMed Central

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

    2016-01-01

    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 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

  15. 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…

  16. Educational Accountability: Characteristics of Legislative Mandates for State Assessment.

    ERIC Educational Resources Information Center

    Buchmiller, Archie A.

    Legislation enacted to attain educational accountability is discussed. At present, 23 states have such enactments. The major kinds of accountability enacted in each of these states are one or more of the following: PPBS, MIS, Uniform Accounting, Testing, Evaluation of Professional Employees, and Performance Contracting. The three most frequently…

  17. 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…

  18. 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…

  19. State mandated public reporting and outcomes of percutaneous coronary intervention in the United States.

    PubMed

    Cavender, Matthew A; Joynt, Karen E; Parzynski, Craig S; Resnic, Frederick S; Rumsfeld, John S; Moscucci, Mauro; Masoudi, Frederick A; Curtis, Jeptha P; Peterson, Eric D; Gurm, Hitinder S

    2015-06-01

    Public reporting has been proposed as a strategy to improve health care quality. Percutaneous coronary interventions (PCIs) performed in the United States from July 1, 2009, to June 30, 2011, included in the CathPCI Registry were identified (n = 1,340,213). Patient characteristics and predicted and observed in-hospital mortality were compared between patients treated with PCI in states with mandated public reporting (Massachusetts, New York, Pennsylvania) and states without mandated public reporting. Most PCIs occurred in states without mandatory public reporting (88%, n = 1,184,544). Relative to patients treated in nonpublic reporting states, those who underwent PCI in public reporting states had similar predicted in-hospital mortality (1.39% vs 1.37%, p = 0.17) but lower observed in-hospital mortality (1.19% vs 1.41%, adjusted odds ratio [ORadj] 0.80; 95% confidence interval [CI] 0.74, 0.88; p <0.001). In patients for whom outcomes were available at 180 days, the differences in mortality persisted (4.6% vs 5.4%, ORadj 0.85, 95% CI 0.79 to 0.92, p <0.001), whereas there was no difference in myocardial infarction (ORadj 0.97, 95% CI 0.89 to 1.07) or revascularization (ORadj 1.05, 95% CI 0.92 to 1.20). Hospital readmissions were increased at 180 days in patients who underwent PCI in public reporting states (ORadj 1.08, 95% CI 1.03 to 1.12, p = 0.001). In conclusion, patients who underwent PCI in states with mandated public reporting of outcomes had similar predicted risks but significantly lower observed risks of death during hospitalization and in the 6 months after PCI. These findings support considering public reporting as a potential strategy for improving outcomes of patients who underwent PCI although further studies are warranted to delineate the reasons for these differences.

  20. Local Assessment Responses to a State-Mandated Minimum-Competency Testing Program: Benefits and Drawbacks.

    ERIC Educational Resources Information Center

    Ferrara, Steven; And Others

    A study was undertaken to describe assessment activities of four school districts in Maryland (Washington, Cecil, Montgomery, and Charles Counties) designed to parallel a state-mandated competency-testing program required for high school graduation and to report uses of scores and positive and negative impacts from assessment activities. The…

  1. 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…

  2. 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)…

  3. Assessing Outcomes of Higher Education in Colorado: Initial Library Participation in State Legislature Mandated Assessment.

    ERIC Educational Resources Information Center

    Alm, Mary L.; And Others

    In response to a state mandate, the University of Northern Colorado (UNC) created an administrative structure, the University Assessment Committee (UAC), to assess the institution's educational merit. Representing the university library was the University Library Assessment Committee (ULAC). The ULAC used two surveys, one for faculty and one for…

  4. 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…

  5. A Study of the Relationship between Students' Anxiety and Test Performance on State-Mandated Assessments

    ERIC Educational Resources Information Center

    Hernandez, Rosalinda; Menchaca, Velma; Huerta, Jeffery

    2011-01-01

    This study examined whether relationships exist between Hispanic fourth-grade students' anxiety and test performance on a state-mandated writing assessment. Quantitative methodologies were employed by using test performance and survey data from 291 participants. While no significantly direct relationship exists between students' levels of anxiety…

  6. Counting state-lead enforcement NPL sites toward the CERCLA Section 116(e) remedial-action start mandate

    SciTech Connect

    Not Available

    1988-10-21

    The directive outlines the criteria and procedures for counting State-lead enforcement National Priorities List sites toward the CERCLA section 116(e) remedial action start mandate. The guidance supplements directive no. 9355.0-24 OSWER Strategy for Management Oversight of the CERCLA RA Start Mandate, dated December 28, 1987.

  7. The Exploration of Demographics and Computer Adaptive Testing in Predicting Performance on State-Mandated Reading Assessments

    ERIC Educational Resources Information Center

    Maziarz, Amy L.

    2010-01-01

    No Child Left Behind (NCLB, 2001) included a broad spectrum of changes to the federal role in public education, including accountability provisions that mandated states to test all students. In an atmosphere of educational reform and federally mandated high-stakes testing, demands have increased for progress monitoring strategies that reliably…

  8. Single payer as a financing mechanism.

    PubMed

    Glied, Sherry

    2009-08-01

    This article uses Organisation for Economic Co-operation and Development (OECD) data to assess whether a single-payer health system delivers more care at less cost than do other universal coverage models. Single-payer plans are defined as those that rely on a limited number of revenue sources and systems in which financing is concentrated and private insurance for hospital and medical services is limited. Single-payer advocates argue that this organizational model is best able to reduce administrative costs, control provider payments, and limit the supply of services. This analysis shows that single-payer-like systems do not do a consistently better job of controlling physician incomes but do achieve some administrative cost savings compared to more fragmented systems. Overall, single-payer systems are modestly less costly than their peers and spend a slightly smaller share of the gross domestic product (GDP) on health. There are, however, substantial variations both over time and across countries in the performance of the single-payer-like nations, as well as among the nations in the other universal coverage model categories. Overall, the differences in system performance among the universal coverage OECD countries are very small, while the difference between the performance of any one of these countries and the United States is enormous and persistent.

  9. “Prefacing the Script” as an Ethical Response to State-Mandated Abortion Counseling

    PubMed Central

    Lassiter, Dragana; Mercier, Rebecca; Bryant, Amy; Lyerly, Anne Drapkin

    2016-01-01

    BACKGROUND Laws governing abortion provision are proliferating throughout the United States, yet little is known about how these laws affect providers. We investigated the experiences of abortion providers in North Carolina practicing under the 2011 Women’s Right to Know Act, which mandates that women receive counseling with specific, state-prescribed information at least 24 hours prior to an abortion. We focus here on a subset of the data to examine one strategy by which providers worked to minimize moral conflicts generated by the counseling procedure. Drawing on Erving Goffman’s work on language and social interaction, we highlight how providers communicated moral objections and layered meanings through a practice that we call prefacing the script. METHODS We conducted semi-structured interviews with 31 physicians, nurses, physician assistants, and clinic managers who provide abortion care in North Carolina. Audio-recorded interviews were transcribed verbatim and analyzed using an inductive, iterative analytic approach, which included reading for context, interpretive memo-writing, and focused coding. RESULTS Roughly half of the participants (14/31) reported that they or the clinicians who performed the counseling in their institution routinely prefaced the counseling script with qualifiers, disclaimers, and apologies that clarified their relationship to the state-mandated content. We identified three performative functions of this practice: 1) enacting a frame shift from a medical to a legal interaction, 2) distancing the speaker from the authorial voice of the counseling script, and 3) creating emotional alignment. CONCLUSIONS Prefacing state-mandated abortion counseling scripts constitutes a practical strategy providers use to balance the obligation to comply with state law with personal and professional responsibilities to provide tailored care, emotional support, and serve the patient’s best interests. Our findings suggest that language constitutes a

  10. The Effects of State-Mandated Abstinence-Based Sex Education on Teen Health Outcomes.

    PubMed

    Carr, Jillian B; Packham, Analisa

    2017-04-01

    In 2011, the USA had the second highest teen birth rate of any developed nation, according to the World Bank, . In an effort to lower teen pregnancy rates, several states have enacted policies requiring abstinence-based sex education. In this study, we utilize a difference-in-differences research design to analyze the causal effects of state-level sex education policies from 2000-2011 on various teen sexual health outcomes. We find that state-level abstinence education mandates have no effect on teen birth rates or abortion rates, although we find that state-level policies may affect teen sexually transmitted disease rates in some states. Copyright © 2016 John Wiley & Sons, Ltd.

  11. 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.

  12. Hospital compliance with a state unfunded mandate: the case of California's Earthquake Safety Law.

    PubMed

    McCue, Michael J; Thompson, Jon M

    2012-01-01

    Abstract In recent years, community hospitals have experienced heightened regulation with many unfunded mandates. The authors assessed the market, organizational, operational, and financial characteristics of general acute care hospitals in California that have a main acute care hospital building that is noncompliant with state requirements and at risk of major structural collapse from earthquakes. Using California hospital data from 2007 to 2009, and employing logistic regression analysis, the authors found that hospitals having buildings that are at the highest risk of collapse are located in larger population markets, possess smaller market share, have a higher percentage of Medicaid patients, and have less liquidity.

  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. 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.

  15. 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. PMID:27226840

  16. 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…

  17. 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…

  18. 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…

  19. Two Case Studies of Beginning Teachers in State-Mandated Induction Programs: The Influence of Institutional Factors.

    ERIC Educational Resources Information Center

    Paulissen, Margaret O.; And Others

    The Teacher Induction Study investigated 2 state-mandated beginning teacher programs and examined the translation of state policy by 4 school districts, 13 individual schools, and 32 classrooms. From the case histories of 16 teams, 2 case histories were selected for further study. One case illustrated how institutional factors influenced team…

  20. State-mandated accountability as a constraint on teaching and learning science

    NASA Astrophysics Data System (ADS)

    Wood, Terry

    The purpose of this study is to examine the effect of state-mandated policy, emphasizing control through performance-based instruction and student test scores as the basis for determining school accreditation, on the teaching and learning of science. The intended consequence of instigating the rational theory of management by one state is to improve their current level of student literacy. However, some contend that the implementation of the policy has results that are not intended. The identification of the tension between the intended and unintended results of centralized policy making is the basis for examining a specific case in which the rational model is implemented. One hundred and sixty-five seventh-grade science students and four teachers are participants in the study. Qualitative analysis is the research methodology used as a means to provide detailed information about the contextual nature of the classroom processes. The intention is to identify and describe features of the behavior setting that influence the behavior of the teachers and their students. Three assertions generated during the field work were: Teachers redefine the goals of science instruction as the acquisition of facts and isolated skills, teachers alter their usual instructional behavior to implement uniform instructional procedures, and the teacher/student classroom interaction constrains students' opportunities to learn science. The implications of the study indicate that the state-mandated policy has results that are in opposition to the intended results. Instead of improving the practices of teachers, the implementation of the policy constrains and routinizes the teachers' behavior, causing them to violate their own standards of good teaching. They feel pressured to get through the materials so students will score well on tests. The classroom interaction is structured in such a way as to inhibit students from asking questions of their own. As a result, students' opportunity to

  1. Score comparability of standard and nonstandard administrations of a state-mandated fifth grade science assessment

    NASA Astrophysics Data System (ADS)

    Randall, Cheryl Ann

    This study investigated the score comparability of a state-mandated science achievement test across three groups of students: (a) general education students, (b) learning disabled students without a reading accommodation, and (c) learning disabled students with a reading accommodation. The main purpose of the study was to determine whether the meaning of the total score is changed when learning disabled students are offered a reading accommodation. Comparability of scores was addressed on three different levels: (a) comparability of reliabilities across groups, (b) comparability of individual item functioning across groups, and (c) comparable factor structure across groups. The results clearly showed comparable reliabilities, comparable individual item functioning, and invariant factor structure even at the highest levels of comparison across groups. The results add to a growing body of evidence that some accommodations may be made for students with disabilities without changing the construct being measured by an assessment. This would allow scores from those particular nonstandard test administrations to be aggregated with scores from a standard test administration.

  2. 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…

  3. 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…

  4. An Ethnographic Policy Analysis of a Michigan High School's Implementation of State-Mandated Universal College Preparatory Curricula

    ERIC Educational Resources Information Center

    Bair, David E.; Bair, Mary Antony

    2011-01-01

    Although many states mandate college preparatory curricula for all high school students, there is no conclusive evidence regarding the benefits of this effort. Furthermore, we know little about how schools interpret and implement such policies. This extended ethnographic case study included a 4 year examination of 1 Michigan high school's response…

  5. 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…

  6. 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…

  7. The Association of State Legal Mandates for Data Submission of Central Line-associated Blood Stream Infections in Neonatal Intensive Care Units with Process and Outcome Measures

    PubMed Central

    Zachariah, Philip; Reagan, Julie; Furuya, E. Yoko; Dick, Andrew; Liu, Hangsheng; Herzig, Carolyn T.A; Pogorzelska-Maziarz, Monika; Stone, Patricia W.; Saiman, Lisa

    2014-01-01

    Objective To determine the association between state legal mandates for data submission of central line-associated blood stream infections (CLABSIs) in neonatal intensive care units (NICUs) with process/outcome measures. Design Cross-sectional study. Participants National sample of level II/III and III NICUs participating in National Healthcare Safety Network (NHSN) surveillance. Methods State mandates for data submission of CLABSIs in NICUs in place by 2011 were compiled and verified with state healthcare-associated infection coordinators. A web-based survey of infection control departments in October 2011 assessed CLABSI prevention practices i.e. compliance with checklist and bundle components (process measures) in ICUs including NICUs. Corresponding 2011 NHSN NICU CLABSI rates (outcome measures) were used to calculate Standardized Infection Ratios (SIR). The association between mandates and process/outcome measures was assessed by multivariable logistic regression. Results Among 190 study NICUs, 107 (56.3%) NICUs were located in states with mandates, with mandates in place for 3 or more years for half. More NICUs in states with mandates reported ≥95% compliance to at least one CLABSI prevention practice (52.3% – 66.4%) than NICUs in states without mandates (28.9% – 48.2%). Mandates were predictors of ≥95% compliance with all practices (OR 2.8; 95% CI 1.4–6.1). NICUs in states with mandates reported lower mean CLABSI rates in the <750gm birth-weight group (2.4 vs. 5.7 CLABSIs/1000 CL-days) but not in others. Mandates were not associated with SIR <1. Conclusions State mandates for NICU CLABSI data submission were significantly associated with ≥95% compliance with CLABSI prevention practices but not with lower CLABSI rates. PMID:25111921

  8. 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.

  9. The impact of state-mandated, high-stakes testing on fifth-grade science teachers' instructional practices

    NASA Astrophysics Data System (ADS)

    Hebert, Terri Richardson

    The appropriate methods utilized by school districts across the United States to measure student academic achievement has found an established place within the headlines of state and national newspapers, professional journals, and political offices. However, we seldom reach out to those in the classroom and engage in a meaningful dialogue about the pros and cons of high stakes, state mandated testing. Therefore, this study is designed to investigate the impact of the Texas Assessment of Knowledge and Skills (TAKS) test upon three fifth grade science teachers' instructional practices. The participating school, nestled within a large East Texas school district, was selected because of their high test scores, as well as their creative approach to teaching. The selected teachers were chosen primarily for their recognized abilities within a science classroom, specifically as they work to reach a diverse group of students at varying levels of ability and instill within them the ability to master necessary scientific concepts found on the state-mandated, high-stakes test. Using the portraiture methodology for this qualitative study (Lawrence-Lightfoot & Davis, 1997), data were collected that provide a rich texture of the fifth grade classes within the elementary school setting. Through close observations, formal and informal interviews, and attention to the teachers' reflective work, the woven tapestry emerged in conjunction with the voices of the teachers.

  10. Patient care cancer clinical trials at the National Cancer Institute: a resource for payers and providers.

    PubMed

    Pearson, Deborah

    2002-01-01

    Clinical trials form the evidence base for medical decision making and may provide patients with life-threatening conditions their best chance to find an effective treatment. A growing number of states and the federal government are mandating coverage of the routine costs of cancer clinical trials, although the extent of coverage varies. Individual health plans are following suit on behalf of their beneficiaries. Trials conducted at the National Cancer Institute (NCI) are an attractive resource for payers, because NCI provides medical services at no charge, enables patient access to promising care, emphasizes continuity with patients' regular physicians, and makes the referral and enrollment process easy and efficient through its Clinical Studies Support Center's toll-free information line 1-888-NCI-1937.

  11. An (un)clear conscience clause: the causes and consequences of statutory ambiguity in state contraceptive mandates.

    PubMed

    VanSickle-Ward, Rachel; Hollis-Brusky, Amanda

    2013-08-01

    Since 1996, twenty-eight states have adopted legislation mandating insurance coverage of prescription contraceptives for women. Most of these policies include language that allows providers to opt out of the requirement because of religious or moral beliefs-conscience clause exemptions. There is striking variation in how these exemptions are defined. This article investigates the sources and consequences of ambiguous versus precise statutory language in conscience clauses. We find that some forms of political and institutional fragmentation (party polarization and gubernatorial appointment power) are correlated with the degree of policy specificity in state contraceptive mandates. This finding reinforces previous law and policy scholarship that has shown that greater fragmentation promotes ambiguous statutory language because broad wording acts as a vehicle for compromise when actors disagree. Interestingly, it is the more precisely worded statutes that have prompted court battles. We explain this with reference to the asymmetry of incentives and mobilizing costs between those disadvantaged by broad (primarily female employees) versus precisely worded statutes (primarily Catholic organizations). Our findings suggest that the impact of statutory ambiguity on court intervention is heavily contextualized by the resources and organization of affected stakeholders.

  12. Disconnects between news framing and parental discourse concerning the state-mandated HPV vaccine: implications for dialogic health communication and health literacy.

    PubMed

    St John, Burton; Pitts, Margaret; Tufts, Kimberly Adams

    2010-01-01

    In 2007, Virginia became the first state in the US to mandate the human papillomavirus (HPV) vaccine. In 2009, the mandate required that parents of girls entering sixth grade (ages 11-12) vaccinate their daughters or sign the 'opt-out' waiver. This investigation is the first to explore how both the news media and parents framed and responded to the newly-mandated HPV vaccine. This research reveals disjoints between news media framing and parental framing. Implications of these gaps for parental healthcare decision-making are addressed and suggestions are offered for constructing a more dialogic, community-based approach that can increase health literacy regarding the HPV vaccine.

  13. State Law, Policy, and Access to Information: The Case of Mandated Openness in Higher Education

    ERIC Educational Resources Information Center

    McLendon, Michael K.; Hearn, James C.

    2010-01-01

    Background/Context: Every state in the nation has legal requirements, state "sunshine laws," to ensure accountability and fairness in institutions receiving state funds and operating under state authority. These laws have come to significantly influence the ways in which the business of higher education is conducted. Purpose/Objective/Research…

  14. 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.

  15. 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

  16. 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…

  17. 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.

  18. A Model for State Technology Planning in Response to Federal Mandate. Project TAARK.

    ERIC Educational Resources Information Center

    Parette, Howard P., Jr.; VanBiervliet, Alan

    The paper describes a state (Arkansas) planning process for delivering appropriate technology support services to citizens with disabilities as implemented in the TAARK (Technology Access for Arkansans) Project and the ARTAP (Arkansas Technology Access Program). The model focuses on active consumer involvement and a comprehensive service delivery…

  19. 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…

  20. States to Face Uniform Rules on Grad Data: Spellings to Propose Formula; Extent of Mandates Unclear

    ERIC Educational Resources Information Center

    Hoff, David J.

    2008-01-01

    This article reports on plans by the Bush administration to set a uniform way for states to calculate and report their graduation rates, which could make it harder for high schools to avoid accountability measures under the No Child Left Behind Act. In the U.S. Department of Education's latest move to refine the implementation of the NCLB law,…

  1. 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,…

  2. Weighing in: Rural Iowa Principals' Perceptions of State-Mandated Teaching Evaluation Standards

    ERIC Educational Resources Information Center

    Lasswell, Terri A.; Pace, Nicholas J.; Reed, Gregory A.

    2008-01-01

    As the accountability movement has gained momentum, policy makers and educators have strived to strike a difficult balance between the sometimes competing demands at the local, state, and federal levels. Efforts to improve accountability and teacher evaluation have taken an especially unique route in Iowa, where local control and resistance to…

  3. Mandated Reporters' Perceptions of and Encounters With Domestic Minor Sex Trafficking of Adolescent Females in the United States.

    PubMed

    Hartinger-Saunders, Robin M; Trouteaud, Alex R; Matos Johnson, Jodien

    2016-03-17

    This is the first study to explore whether mandated reporters who work with adolescent females, ages 10 to 17, recognize domestic minor sex trafficking (DMST) and associated risk factors. Because mandated reporters are required by law to report child abuse, neglect, and child exploitation, lack of specific DMST training or not believing DMST exists in communities continues to place young females at risk for revictimization. Results indicate that 60% of mandated reporters in the sample (N = 577) had no specific training on DMST. Furthermore, almost 25% of respondents did not believe DMST existed in their communities. Implications for practice are discussed. (PsycINFO Database Record

  4. 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

  5. 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…

  6. 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…

  7. 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,…

  8. Arming your practice with the payer's data.

    PubMed

    Collier, John; Carden, Carol

    2006-01-01

    Negotiation of the most favorable managed rates may be the best opportunity you have to meet the revenue goals of the practice. When participating in a negotiation you should arm yourself with all the knowledge and tools available. This article discusses some of the public filings made annually by payers and how to use the data, the payer's own data, to enhance your negotiating position.

  9. 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

  10. A Law...A Plan: Coordination Mandated.

    ERIC Educational Resources Information Center

    Lewis, Carol J.; Murphy, Joyce Young

    1981-01-01

    Educational legislation mandated that state education agencies submit plans for the coordination of federal and state funds for school staff development. State activities in planning, preparing, and coordinating programs are identified and discussed. (JN)

  11. Assessing the cost burden of United States FDA-mandated post-approval studies for medical devices.

    PubMed

    Wimmer, Neil J; Robbins, Susan; Ssemaganda, Henry; Yang, Erin; Normand, Sharon-Lise; Matheny, Michael E; Herz, Naomi; Rising, Josh; Resnic, Frederic S

    2016-01-01

    Approved medical devices frequently undergo FDA mandated post-approval studies (PAS). However, there is uncertainty as to the value of PAS in assessing the safety of medical devices and the cost of these studies to the healthcare system is unknown. Since PAS costs are funded through device manufacturers who do not share the costs with regulators, we sought to estimate the total PAS costs through interviews with a panel of experts in medical device clinical trial design in order to design a general cost model for PAS which was then applied to the FDA PAS. A total of 277 PAS were initiated between 3/1/05 through 6/30/13 and demonstrated a median cost of $2.16 million per study and an overall cost of $1.22 billion over the 8.25 years of study. While these costs are funded through manufacturers, the ultimate cost is borne by the healthcare system through the medical device costs. Given concerns regarding the informational value of PAS, the resources used to support mandated PAS may be better allocated to other approaches to assure safety.

  12. Assessing the cost burden of United States FDA-mandated post-approval studies for medical devices

    PubMed Central

    Wimmer, Neil J.; Robbins, Susan; Ssemaganda, Henry; Yang, Erin; Normand, Sharon-Lise; Matheny, Michael E.; Herz, Naomi; Rising, Josh; Resnic, Frederic S.

    2016-01-01

    Approved medical devices frequently undergo FDA mandated post-approval studies (PAS). However, there is uncertainty as to the value of PAS in assessing the safety of medical devices and the cost of these studies to the healthcare system is unknown. Since PAS costs are funded through device manufacturers who do not share the costs with regulators, we sought to estimate the total PAS costs through interviews with a panel of experts in medical device clinical trial design in order to design a general cost model for PAS which was then applied to the FDA PAS. A total of 277 PAS were initiated between 3/1/05 through 6/30/13 and demonstrated a median cost of $2.16 million per study and an overall cost of $1.22 billion over the 8.25 years of study. While these costs are funded through manufacturers, the ultimate cost is borne by the healthcare system through the medical device costs. Given concerns regarding the informational value of PAS, the resources used to support mandated PAS may be better allocated to other approaches to assure safety. PMID:28280294

  13. 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…

  14. 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.

  15. 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

  16. 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…

  17. The individual mandate: implications for public health law.

    PubMed

    Parmet, Wendy E

    2011-01-01

    No provision of the Patient Protection and Affordable Care Act (PPACA) has been more contentious than the so-called "individual mandate," the constitutionality of which is now before several appellate courts. Critics claim that the mandate represents an unprecedented attempt by the federal government to compel individual action. Yet, states frequently employ similar mandates to protect the public's health. These public health mandates have also often aroused deep opposition. This essay situates PPACA's mandate, and the opposition to it, in that broader context. The article reviews the arguments that public health's population perspective provides in support of mandates, as well as the reasons why mandates often ignite intense legal and political opposition. Most importantly, by holding individuals accountable for population-based problems, mandates may undercut the public health arguments that justify them. The article concludes by arguing that public health policymakers need to know more about the unintended political and legal costs of mandates.

  18. 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;…

  19. 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 impact of…

  20. 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.

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

    DOE PAGES

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

    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

  2. Spina bifida and anencephaly before and after folic acid mandate--United States, 1995-1996 and 1999-2000.

    PubMed

    2004-05-07

    Neural tube defects (NTDs) are serious birth defects of the spine (e.g., spina bifida) and the brain (e.g., anencephaly) that occur during early pregnancy, often before a woman knows she is pregnant; 50%-70% of these defects can be prevented if a woman consumes sufficient folic acid daily before conception and throughout the first trimester of her pregnancy. In 1992, to reduce the number of cases of spina bifida and other NTDs, the U.S. Public Health Service (USPHS) recommended that all women capable of becoming pregnant consume 400 microg of folic acid daily. Three approaches to increase folic acid consumption were cited: 1) improve dietary habits, 2) fortify foods with folic acid, and 3) use dietary supplements containing folic acid. Mandatory fortification of cereal grain products went into effect in January 1998; during October 1998-December 1999, the reported prevalence of spina bifida declined 31%, and the prevalence of anencephaly declined 16%. Other studies have indicated similar trends. To update the estimated numbers of NTD-affected pregnancies and births, CDC recently analyzed data from 23 population-based surveillance systems that include prenatal ascertainment of these birth defects. This report summarizes the results of that analysis, which indicate that the estimated number of NTD-affected pregnancies in the United States declined from 4,000 in 1995-1996 to 3,000 in 1999-2000. This decline in NTD-affected pregnancies highlights the partial success of the U.S. folic acid fortification program as a public health strategy. To reduce further the number of NTD-affected pregnancies, all women capable of becoming pregnant should follow the USPHS recommendation and consume 400 microg of folic acid every day.

  3. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Certain payers excluded. 220.6 Section 220.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6...

  4. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Certain payers excluded. 220.6 Section 220.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6...

  5. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 2 2013-07-01 2013-07-01 false Certain payers excluded. 220.6 Section 220.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6...

  6. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Certain payers excluded. 220.6 Section 220.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6...

  7. 32 CFR 220.6 - Certain payers excluded.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Certain payers excluded. 220.6 Section 220.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE SERVICES § 220.6...

  8. 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.

  9. 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... section. (1) Pursuant to 38 U.S.C. 1729(b)(2), the United States may file a claim or institute and prosecute legal proceedings against a third-party payer to enforce a right of the United States under 38...

  10. 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…

  11. Occupational Stereotyping. The Mandate-Condition-Need.

    ERIC Educational Resources Information Center

    Woal, S. Theodore

    A review of the present situation of occupational stereotyping introducing this document suggests that the legal mandate and implementation on the federal, state, and local levels apparently have not been followed by establishments serving the educational field, nor by educational institutions themselves. From a discussion of studies done on…

  12. 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…

  13. Training and Mandated Reporters' Confidence Levels: A Correlational Study

    ERIC Educational Resources Information Center

    Eichelberger, Cathy S.

    2011-01-01

    Child maltreatment is a costly social issue, both financially and in terms of children's well-being. All 50 states and many countries have enacted mandatory reporting laws, but not all of them require mandated reporter training. A multitude of studies have shown that many mandated reporters do not report all of the cases of suspected child abuse…

  14. 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.

  15. How Do Payers Respond to Regulatory Actions? The Case of Bevacizumab

    PubMed Central

    Dusetzina, Stacie B.; Ellis, Shellie; Freedman, Rachel A.; Conti, Rena M.; Winn, Aaron N.; Chambers, James D.; Alexander, G. Caleb; Huskamp, Haiden A.; Keating, Nancy L.

    2015-01-01

    Purpose: In February 2008, the US Food and Drug Administration (FDA) granted accelerated approval for bevacizumab for metastatic breast cancer. After public hearings in July 2010, and June 2011, the FDA revoked this approved indication in November 2011, on the basis of additional evidence regarding its risk/benefit profile. The Centers for Medicare and Medicaid Services, local Medicare contractors, and commercial payers varied in their stated intentions to cover bevacizumab after FDA's regulatory actions. We examined payer-specific trends in bevacizumab use after the FDA's regulatory actions. Methods: We used outpatient medical claims compiled by IMS Health to evaluate trends in bevacizumab use for breast cancer for Medicare-insured and commercially insured patients (N = 102,906) using segmented regression. Given that Medicare coverage policies may vary across regional contractors, we estimated trends in bevacizumab use across 10 local coverage areas. In a sensitivity analysis, we estimated trends in bevacizumab use for breast cancer compared with trends in use for lung cancer using difference-in-differences models. Results: Among chemotherapy infusions for breast cancer, bevacizumab use decreased from 31% in July 2010, to 4% in September 2012. Use decreased by 11% among commercially insured and 13% among Medicare-insured patients after July 2010 (interaction P = .68) and continued to decline by 9% per month (interaction P = .61). We observed no contractor-level variation in bevacizumab use among Medicare beneficiaries. During the same period, bevacizumab use for lung cancer was stable. Conclusion: Although insurers varied in public statements regarding coverage intentions, bevacizumab use declined similarly among all payers, suggesting that provider decision making, rather than payer-specific coverage policies, drove reductions. PMID:26060224

  16. The HPV vaccine mandate controversy.

    PubMed

    Haber, Gillian; Malow, Robert M; Zimet, Gregory D

    2007-12-01

    In this editorial we address the controversies surrounding human papillomavirus (HPV) vaccine school-entry mandate legislation, but differentiate between the mandate debate and issues specific to the vaccine itself. Our goal is not to take a stand in favor of or opposed to mandates, but rather to critically examine the issues. We discuss the following arguments against HPV vaccine school-entry requirements: 1. The public health benefit of mandated HPV vaccination is not sufficient to warrant the intrusion on parental autonomy; 2. A vaccine that prevents a non-casually transmitted infection should not be mandated; 3. Opt-out provisions are inherently unfair to parents who oppose HPV vaccination; 4. Limited health care dollars should not be directed toward cervical cancer prevention; and 5. The vaccine is expensive and potential problems with supply suggest that mandates should not be implemented until insurance coverage and supply issues are resolved. Next, we critically evaluate the following critiques of HPV vaccination itself: 1. Giving girls HPV vaccine implies tacit consent to engage in sexual activity; 2. Giving girls this vaccine will confer a false sense of protection from sexually transmitted infections and will lead to sexual disinhibition; 3. Children already have too many vaccinations on the immunization schedule; 4. Long-term side effects of HPV vaccine are unknown; 5. The vaccine's enduring effectiveness is unknown and booster shots may be required; and 6. It is wrong to only target girls with HPV vaccine; boys should be vaccinated as well.

  17. 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 §...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422... enrollees with the benefits of the primary payers, including reporting, on an ongoing basis, information... instructions. (c) Collecting from other entities. The MA organization may bill, or authorize a provider to...

  19. 42 CFR 423.462 - Medicare secondary payer procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.462 Medicare secondary payer procedures. (a) General... to Part D sponsors and Part D plans (with respect to the offering of qualified prescription...

  20. Roles of the federal and state governments in outcomes assessment.

    PubMed

    Epstein, M H; McGee, J L

    1996-01-01

    Both federal and state governments have mandates to collect, analyze, and disseminate health care information. The federal government is the single largest payer for health care and health services research. Its agencies, the Healthcare Finance Administration (HCFA) and the Agency for Healthcare Policy Research (AHCPR) play a major role in shaping information strategies for all health care stakeholders. State governments are among those stakeholders and are fertile grounds for experimentation, change, and learning. Building effective federal-state partnerships and public-private partnerships can help foster innovation in health data collection and analysis, as well as identify new strategies for information dissemination.

  1. Bilingual Education Mandate: A Preliminary Report.

    ERIC Educational Resources Information Center

    Illinois State Board of Education, Springfield.

    The legislative mandate for bilingual education in Illinois was analyzed in order to evaluate the effectiveness of the mandate. Questions were addressed concerning the desired outcome of the mandate, the actual outcomes, and potential alternatives for bringing about the desired outcome. The history of the mandate for bilingual education and…

  2. School Day/School Year Mandates. 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 school day/school year 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…

  3. Predictors of Payer Mix and Financial Performance Among Safety Net Hospitals Prior to the Affordable Care Act.

    PubMed

    Sommers, Benjamin D; Stone, Juliana; Kane, Nancy

    2016-01-01

    The objective of this study was to use audited hospital financial statements to identify predictors of payer mix and financial performance in safety net hospitals prior to the Affordable Care Act. We analyzed the 2010 financial statements of 98 large, urban safety net hospital systems in 34 states, supplemented with data on population demographics, hospital features, and state policies. We used multivariate regression to identify independent predictors of three outcomes: 1) Medicaid-reliant payer mix (hospitals for which at least 25% of hospital days are paid for by Medicaid); 2) safety net revenue-to-cost ratio (Medicaid and Medicare Disproportionate Share Hospital payments and local government transfers, divided by charity care costs and Medicaid payment shortfall); and 3) operating margin. Medicaid-reliant payer mix was positively associated with more inclusive state Medicaid eligibility criteria and more minority patients. More inclusive Medicaid eligibility and higher Medicaid reimbursement rates positively predicted safety net revenue-to-cost ratio. University governance was the strongest positive predictor of operating margin. Safety net hospital financial performance varied considerably. Academic hospitals had higher operating margins, while more generous Medicaid eligibility and reimbursement policies improved hospitals' ability to recoup costs. Institutional and state policies may outweigh patient demographics in the financial health of safety net hospitals.

  4. 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…

  5. 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

  6. 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...

  7. 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...

  8. 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.

  9. 32 CFR 220.2 - Statutory obligation of third party payer to pay.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... healthcare services provided in or through any facility of the Uniformed Services to a covered...

  10. 32 CFR 220.2 - Statutory obligation of third party payer to pay.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... healthcare services provided in or through any facility of the Uniformed Services to a covered...

  11. 32 CFR 220.2 - Statutory obligation of third party payer to pay.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... healthcare services provided in or through any facility of the Uniformed Services to a covered...

  12. 32 CFR 220.2 - Statutory obligation of third party payer to pay.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... healthcare services provided in or through any facility of the Uniformed Services to a covered...

  13. 32 CFR 220.2 - Statutory obligation of third party payer to pay.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... healthcare services provided in or through any facility of the Uniformed Services to a covered...

  14. Financing care for the uninsured: the dilemma vexes New Jersey hospitals and payers.

    PubMed

    Wells, E V

    1996-05-01

    New Jersey's diverse constituencies and special interest groups don't usually agree on a public policy issue. However, almost everyone in the public policy arena agrees that hospitals should treat people who show up in emergency departments with problems requiring medical attention. For over a decade, Garden State policymakers, payers, and providers have faced the dilemma of excess demand on hospitals that treat the uninsured. This demand has risen due to increasing health care costs, development of costly technology, state deregulation of hospital payments, and employers' reluctance to insure workers and their families coupled with a mobile workforce holding part-time and seasonal jobs. The fiscal solvency of inner-city hospitals is threatened yet the problem continues to elude resolution.

  15. Embryo transfer practices and perinatal outcomes by insurance mandate status

    PubMed Central

    Boulet, Sheree L.; Crawford, Sara; Zhang, Yujia; Sunderam, Saswati; Cohen, Bruce; Bernson, Dana; McKane, Patricia; Bailey, Marie A.; Jamieson, Denise J.; Kissin, Dmitry M.

    2015-01-01

    Objective To use linked assisted reproductive technology (ART) surveillance and birth certificate data to compare ET practices and perinatal outcomes for a state with a comprehensive mandate requiring coverage of IVF services versus states without a mandate. Design Retrospective cohort study. Setting Not applicable. Patient(s) Live-birth deliveries ascertained from linked 2007–2009 National ART Surveillance System and birth certificate data for a state with an insurance mandate (Massachusetts) and two states without a mandate (Florida and Michigan). Intervention(s) None. Main Outcome Measure(s) Number of embryos transferred, multiple births, low birth weight, preterm delivery. Result(s) Of the 230,038 deliveries in the mandate state and 1,026,804 deliveries in the nonmandate states, 6,651 (2.9%) and 8,417 (0.8%), respectively, were conceived by ART. Transfer of three or more embryos was more common in nonmandate states, although the effect was attenuated for women 35 years or older (33.6% vs. 39.7%; adjusted relative risk [RR], 1.46; 95% confidence interval [CI], 1.17–1.81) versus women younger than 35 (7.0% vs. 26.9%; adjusted RR, 4.18; 95% CI, 2.74–6.36). Lack of an insurance mandate was positively associated with triplet/higher order deliveries (1.0% vs. 2.3%; adjusted RR, 2.44; 95% CI, 1.81–3.28), preterm delivery (22.6% vs. 30.7%; adjusted RR, 1.31; 95% CI, 1.20–1.42), and low birth weight (22.3% vs. 29.5%; adjusted RR, 1.28; 95% CI, 1.17–1.40). Conclusion(s) Compared with nonmandate states, the mandate state had higher overall rates of ART use. Among ART births, lack of an infertility insurance mandate was associated with increased risk for adverse perinatal outcomes. PMID:26051096

  16. 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

    ...; 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 Strengthening... MSP Web portal. It also requires that we add functionality to the existing MSP Web portal that...

  17. 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.

  18. 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…

  19. 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…

  20. Print News Coverage of School-Based HPV Vaccine Mandate

    PubMed Central

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

    2015-01-01

    BACKGROUND In 2007, legislation was proposed in 24 states and the District of Columbia for school-based 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 these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. METHODS We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005-2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. RESULTS Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. CONCLUSIONS If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages, and promote informed decision-making by parents and students. PMID:25099421

  1. 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.

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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

  8. Rapid Expansion of New Oncology Care Delivery Payment Models: Results from a Payer Survey

    PubMed Central

    Greenapple, Rhonda

    2013-01-01

    Background Oncology practices are seeking to adapt to new care delivery models, including accountable care organizations (ACOs), patient-centered medical homes (PCMHs) in oncology, and oncology pathways, as well as new payment models, such as bundled payments or pay-for-performance contracts. Objective Our survey sought to determine which payment models and care delivery models payers view as the most viable and the most potentially impactful in managing and reducing the cost of cancer care. Methods We conducted an online national survey of 49 payers, including 19 medical directors and 30 pharmacy directors, representing more than 100 million covered lives within national and regional plans, using a validated instrument comprised of approximately 120 questions. The survey was administered using the SurveyGizmo website. It was initiated on July 10, 2012, and completed on July 25, 2012. The survey included open- and closed-ended questions and probed payers about models of care that they, in collaboration with providers, are implementing or supporting to improve the quality of cancer care and to reduce the associated costs. Results Payers are rapidly moving to implement new reimbursement models to support new care delivery models, including ACOs and PCMHs. Based on the results of this survey, a minority of payers are experimenting with new oncology payment models, but most payers are evaluating various models, including bundled payments, capitation, shared savings, and pay for performance. Of the payers in this survey, 39% have already implemented oncology pathways, and 59% who have not already done so are planning to implement pathways in 2 years. Input from local oncology experts is an important resource for pathway development, and a substantial majority (95%) of payers will use pathways to address earlier initiation of palliative care discussions where appropriate. Conclusion Payers anticipate that there will be a rapid expansion of the use of innovative

  9. 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

  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. Evaluation of a Congressionally Mandated Wraparound Demonstration

    ERIC Educational Resources Information Center

    Bickman, Leonard; Smith, Catherine M.; Lambert, E. Warren; Andrade, Ana Regina

    2003-01-01

    In order to determine whether expenditures for mental health could be reduced and quality improved, Congress mandated that the Department of Defense conduct a demonstration project utilizing a wraparound mental health service system for child and adolescent military dependents. A longitudinal quasiexperimental design was used to evaluate the…

  12. Mandating Father Involvement: Implications for Special Educators.

    ERIC Educational Resources Information Center

    Lillie, Timothy

    This paper examines issues concerning mandated father involvement with their children, especially as this involvement affects children with special needs. The paper examines four points: (1) the history of the status of fathers, how it has changed, and why father involvement is an issue; (2) current regulations at the federal level which…

  13. Relative efficacy of drugs: an emerging issue between regulatory agencies and third-party payers.

    PubMed

    Eichler, Hans-Georg; Bloechl-Daum, Brigitte; Abadie, Eric; Barnett, David; König, Franz; Pearson, Steven

    2010-04-01

    Drug regulatory agencies have traditionally assessed the quality, safety and efficacy of drugs, and the current paradigm dictates that a new drug should be licensed when the benefits outweigh the risks. By contrast, third-party payers base their reimbursement decisions predominantly on the health benefits of the drug relative to existing treatment options (termed relative efficacy; RE). Over the past decade, the role of payers has become more prominent, and time-to-market no longer means time-to-licensing but time-to-reimbursement. Companies now have to satisfy the sometimes divergent needs of both regulators and payers, and to address RE during the pre-marketing stages. This article describes the current political background to the RE debate and presents the scientific and methodological challenges as they relate to RE assessment. In addition, we explain the impact of RE on drug development, and speculate on future developments and actions that are likely to be required from key players.

  14. Do Insurance Mandates Affect Racial Disparities in Outcomes for Children with Autism?

    PubMed

    Doshi, Pratik; Tilford, J Mick; Ounpraseuth, Songthip; Kuo, Dennis Z; Payakachat, Nalin

    2017-02-01

    Objective The study investigated whether state mandates for private insurers to provide services for children with autism influence racial disparities in outcomes. Methods The study used 2005/2006 and 2009/2010 waves of the National Survey of Children with Special Health Care Needs. Children with a current diagnosis of autism were included in the sample. Children residing in 14 states and the District of Columbia that were not covered by the mandate in the 2005/2006 survey, but were covered in the 2009/2010 survey, served as the mandate group. Children residing in 32 states that were not covered by a mandate in either wave served as the comparison group. Outcome measures assessed included care quality, family economics, and child health. A difference-in-difference-in-differences (DDD) approach was used to assess the impact of the mandates on racial disparities in outcomes. Results Non-white children had less access to family-centered care compared to white children in both waves of data, but this difference was not apparent across mandate and comparison states as only the comparison states had significant differences. Parents of non-white children reported paying less in annual out-of-pocket expenses compared to parents of white children across waves and groups. DDD estimates did not provide evidence that the mandates had statistically significant effects on improving or worsening racial disparities for any outcome measure. Conclusions This study did not find evidence that state mandates on private insurers affected racial disparities in outcomes for children with autism.

  15. Mandating vaccination: what counts as a "mandate" in public health and when should they be used?

    PubMed

    Wynia, Matthew K

    2007-12-01

    Recent arguments over whether certain public health interventions should be mandatory raise questions about what counts as a "mandate." A mandate is not the same as a mere recommendation or the standard of practice. At minimum, a mandate should require an active opt-out and there should be some penalty for refusing to abide by it. Over-loose use of the term "mandate" and the easing of opt-out provisions could eventually pose a risk to the gains that truly mandatory public health interventions, such as childhood vaccines, have provided over the last 50 years. Already, confusion about what counts as a mandate, and about what criteria should be used to determine when a public health intervention should be implemented as a mandate, has led to some inappropriate public policy decisions. For instance, by any reasonable criteria, the yearly influenza vaccine should be mandatory for health care workers. To enforce this mandate, those who refuse vaccination should be required to sign a waiver, and patients - especially those at high risk from flu - should be informed when they receive care from unvaccinated practitioners.

  16. 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.

  17. 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

  18. Packaging effective community service delivery: the utility of mandates and contracts in obtaining administrative cooperation.

    PubMed

    Woodard, K L

    1994-01-01

    Voluntary agreements, mandates, and contracts integrate networks of social service organizations, allowing them to function as coordinated wholes. The author reviews the history of contracting and mandating in the public sector. It is hypothesized that contracted relationships formalize agreements between local organizations dependent on others. Mandated relationships are perceived to be important by policy-makers at a state or federal level. The differential acceptance and rejection of these relationships in the community is explored. Data from social service agencies are used to compare administrators' assessments of the effectiveness of mandated and contracted relationships used to coordinate a group of agencies delivering services to children. When a mandated relationship has been formalized into a contract by a local administrator the perceived effectiveness of that relationship is higher than any other relationship in the community. If the mandated relationship has not been formalized by a contract this relationship is perceived to be the least effective. Important mandated inter-organizational ties without monetary incentives are less likely to work. Local administrators having developed the contracted ties see these ties as producing a higher level of performance.

  19. 42 CFR 411.31 - Authority to bill primary payers for full charges.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Authority to bill primary payers for full charges. 411.31 Section 411.31 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... may pay. (b) With respect to workers' compensation plans, no-fault insurers, and employer group...

  20. 42 CFR 411.31 - Authority to bill primary payers for full charges.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Authority to bill primary payers for full charges. 411.31 Section 411.31 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... may pay. (b) With respect to workers' compensation plans, no-fault insurers, and employer group...

  1. How To Prepare and Present Effective Outcome Reports for External Payers and Regulators.

    ERIC Educational Resources Information Center

    Thompson, Ronald W.; Way, Mona L.

    2000-01-01

    This article describes practical methods for agencies to move from a process to an outcomes focus when preparing and presenting reports to payers and regulators. Essential components of an outcomes system are outlined, and methods for preparing and presenting reports are drawn from experiences at Father Flanagan's Boy's Home. (Contains…

  2. Effects of a Legislated Mandate: "The Comprehensive School Improvement Process and Middle-Level Gifted and Talented Programming"

    ERIC Educational Resources Information Center

    Schneider, Jean Suchsland

    2006-01-01

    This descriptive study investigated two areas: (a) perceived changes in gifted and talented (G/T) programming in Iowa from the time a state mandate was implemented to the time of the study, and (b) perceived effects of the mandate on G/T programming in Iowa. Perceptions of middle-level teachers of gifted and talented students (n = 111) were…

  3. 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 on…

  4. 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.

  5. Factors Influencing Compliance with Legislative Mandates within Information Technology Departments

    ERIC Educational Resources Information Center

    Gioia, Paul J.

    2014-01-01

    Since 2001, information technology (IT) leadership has had to contend with a host of new federal and local regulatory mandates. The purpose of this quantitative study was to identify and assess the possible inefficiencies associated with efforts to comply with recent legislative IT mandates and to model the impact of these mandates on the…

  6. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  7. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  8. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  9. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  10. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  11. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  12. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  13. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490.302 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule....

  14. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  15. 10 CFR 490.305 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Acquisitions satisfying the mandate. 490.305 Section 490.305 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle Acquisition Mandate § 490.305 Acquisitions satisfying the mandate....

  16. Third-party payers: to pay or not to pay.

    PubMed

    Sharfstein, S S

    1978-10-01

    Insurance companies have traditionally been wary of providing coverage for mental illness for two reasons: 1) they fear that people would bring a mental illness on themselves or would use treatment for self-actualization, and 2) they fear the risk of providing never-ending treatment for "incurable" illness. The author states that the insurers' fears are groundless but suggests that psychiatrists research the utilization and costs of their treatments in insurance plans collaboratively with the actuaries who determine policy and premiums. Retrospective and prospective criteria for outcome and effectiveness of psychiatric treatment must be developed and applied.

  17. 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

  18. A Comparative Analysis of the Influence of High Stakes Testing Mandates in the Elementary School

    ERIC Educational Resources Information Center

    Inserra, Albert; Bossert, Kenneth R.

    2008-01-01

    The No Child Left Behind Act of 2001, sponsored by President George W. Bush, calls for 100 percent proficiency in reading and mathematics by 2014. This Federal mandate has caused all public schools in the United States to examine the programs in use to meet these requirements. In addition, states across the country have implemented a series of…

  19. Mandated Site-Based Management in Texas: Exploring Implementation in Urban High Schools.

    ERIC Educational Resources Information Center

    Kemper, Elizabeth A.; Teddlie, Charles

    2000-01-01

    Examined implementation of state-mandated site-based management (SBM) in Texas high schools. Teacher and principal surveys indicated that state-level reform policies were subject to interpretation at the school level. Urban schools had high levels of SBM program structure but low teacher perceptions of decision making responsibility. Case studies…

  20. Cost implications to health care payers of improving glucose management among adults with type 2 diabetes.

    PubMed

    Nuckols, Teryl K; McGlynn, Elizabeth A; Adams, John; Lai, Julie; Go, Myong-Hyun; Keesey, Joan; Aledort, Julia E

    2011-08-01

    Objective. To assess the cost implications to payers of improving glucose management among adults with type 2 diabetes. Data Source/Study Setting. Medical-record data from the Community Quality Index (CQI) study (1996-2002), pharmaceutical claims from four Massachusetts health plans (2004-2006), Medicare Fee Schedule (2009), published literature. Study Design. Probability tree depicting glucose management over 1 year. Data Collection/Extraction Methods. We determined how frequently CQI study subjects received recommended care processes and attained Health Care Effectiveness Data and Information Set (HEDIS) treatment goals, estimated utilization of visits and medications associated with recommended care, assigned costs based on utilization, and then modeled how hospitalization rates, costs, and goal attainment would change if all recommended care was provided. Principal Findings. Relative to current care, improved glucose management would cost U.S.$327 (U.S.$192-711 in sensitivity analyses) more per person with diabetes annually, largely due to antihyperglycemic medications. Cost-effectiveness to payers, defined as incremental annual cost per patient newly attaining any one of three HEDIS goals, would be U.S.$1,128; including glycemic crises reduces this to U.S.$555-1,021. Conclusions. The cost of improving glucose management appears modest relative to diabetes-related health care expenditures. The incremental cost per patient newly attaining HEDIS goals enables payers to consider costs as well as outcomes that are linked to future profitability.

  1. 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.

  2. Can Payers Use Prices to Improve Quality? Evidence from English Hospitals.

    PubMed

    Allen, Thomas; Fichera, Eleonora; Sutton, Matt

    2016-01-01

    In most activity-based financing systems, payers set prices reactively based on historical averages of hospital reported costs. If hospitals respond to prices, payers might set prices proactively to affect the volume of particular treatments or clinical practice. We evaluate the effects of a unique initiative in England in which the price offered to hospitals for discharging patients on the same day as a particular procedure was increased by 24%, while the price for inpatient treatment remained unchanged. Using national hospital records for 205,784 patients admitted for the incentivised procedure and 838,369 patients admitted for a range of non-incentivised procedures between 1 December 2007 and 31 March 2011, we consider whether this price change had the intended effect and/or produced unintended effects. We find that the price change led to an almost six percentage point increase in the daycase rate and an 11 percentage point increase in the planned daycase rate. Patients benefited from a lower proportion of procedures reverted to open surgery during a planned laparoscopic procedure and from a reduction in long stays. There was no evidence that readmission and death rates were affected. The results suggest that payers can set prices proactively to incentivise hospitals to improve quality.

  3. Association between payer mix and costs, revenues and profitability: a cross-sectional study of Lebanese hospitals.

    PubMed

    Saleh, S; Ammar, W; Natafgi, N; Mourad, Y; Dimassi, H; Harb, H

    2015-09-08

    This study aimed to examine the association between the payer mix and the financial performance of public and private hospitals in Lebanon. The sample comprised 24 hospitals, representing the variety of hospital characteristics in Lebanon. The distribution of the payer mix revealed that the main sources of revenue were public sources (61.1%), out-of-pocket (18.4%) and private insurance (18.2%). Increases in the percentage of revenue from public sources were associated with lower total costs and revenues, but not profit margins. An inverse association was noted between increased revenue from private insurance and profitability, attributed to increased costs. Increased percentage of out of- pocket payments was associated with lower costs and higher profitability. The study provides evidence that payer mix is associated with hospital costs, revenues and profitability. This should initiate/inform discussions between public and private payers and hospitals about the level of payment and its association with hospital sector financial viability.

  4. VARIATIONS IN THE USE OF AN INNOVATIVE TECHNOLOGY BY PAYER: THE CASE OF DRUG-ELUTING STENTS

    PubMed Central

    Epstein, Andrew J.; Ketcham, Jonathan D.; Rathore, Saif S.; Groeneveld, Peter W.

    2011-01-01

    Background Despite receiving identical reimbursement for treating heart disease patients with bare metal stents (BMS) or drug-eluting stents (DES), cardiologists’ use of the new technology (DES) may have varied by patient payer type as DES diffused. Payer-related factors that differ between hospitals and/or differential treatment inside hospitals might explain any overall differences by payer type. Objectives To assess the association between payer and DES use; and to examine between- and within-hospital variation in DES use over time. Methods We conducted a retrospective analysis of 4.1 million hospitalizations involving DES or BMS from the 2003–2008 Nationwide Inpatient Sample. We estimated hybrid fixed effects logit models and calculated the adjusted within-quarter, cross-payer differences in DES use. Results Coronary stent patients with Medicaid or without insurance were significantly less likely to receive DES than were patients with private insurance throughout the study period. The differences fluctuated over time as the popularity of DES relative to BMS rose and fell. The within-hospital gaps paralleled the overall differences, and were largest in Q3 2003 (Medicaid: 11.9, uninsured: 10.9 percentage points) and Q4 2008 (Medicaid: 12.8, uninsured: 20.7 percentage points), and smallest in Q4 2004 (Medicaid: 1.4, uninsured: 1.1 percentage points). The between-hospital adjusted differences in DES use by payer were small and rarely significant. Conclusions We found substantial differences in DES use by payer within hospitals, suggesting physicians selected the new technology for patients in a manner associated with patients’ payer type. PMID:22167062

  5. 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.

  6. House panel to draft bill mandating testing of newborns.

    PubMed

    1995-07-28

    The Ryan White CARE Act reauthorization bill may be at a standstill. Republican Tom Coburn has argued that all newborns should be tested to protect the health of the infants and alert the mother to seek medical care. He has sought to amend the Ryan White reauthorization measure to mandate HIV testing. The American Medical Association, the National Governors Association, and the Association of State and Territorial Health Officials joined AIDS groups in opposing Coburn's proposal. They contend that the most effective means of protecting babies is through testing and medical intervention during pregnancy. Leaders of the House Commerce Committee agreed that the Ryan White funding would not be used to pay for the cost of testing. It would cost about forty dollars to test each of the nation's four million newborns each year, though most mothers presumably would be covered under private insurance or Medicaid.

  7. Coverage of newborn and adult male circumcision varies among public and private US payers despite health benefits.

    PubMed

    Clark, Sarah J; Kilmarx, Peter H; Kretsinger, Katrina

    2011-12-01

    Studies have shown that male circumcision greatly reduces the risk for heterosexual transmission of HIV, other sexually transmitted infections, infant urinary tract infections, penile cancer, and other adverse health outcomes. Given recent data regarding these health benefits and the cost-effectiveness of newborn male circumcision, national policy makers are developing new recommendations regarding circumcision for newborn, adolescent, and adult males. To investigate the implications, this study assessed insurance coverage and reimbursement for routine newborn and adult male circumcision in private and public health plans in 2009. We found that coverage varies across private and public payers. Private insurance provides far broader coverage than state Medicaid programs for routine newborn male circumcision. Specifically, Medicaid programs in seventeen states do not cover it, even though low-income populations have a higher risk of HIV and other sexually transmitted diseases compared to higher-income groups. For adult male circumcision, coverage is generally sparse across public and private plans. Presentation of evidence-based recommendations--for example, from the Centers for Disease Control and Prevention--may be necessary if coverage for newborn and adult male circumcision is to be expanded.

  8. 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

  9. Lessons from a New Continuing Education Mandate: The Experience of NASW-NYC

    ERIC Educational Resources Information Center

    Schachter, Robert

    2016-01-01

    The New York City Chapter of the National Association of Social Workers (NASW-NYC), one of the largest in the country, launched a continuing education initiative in 2015 in response to passage of a new statute mandating that all MSW-level state licensed social workers begin accumulating approved hours of continuing education as a requirement for…

  10. 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…

  11. 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…

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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…

  18. Developing a Critical Lens among Preservice Teachers while Working within Mandated Performance-Based Assessment Systems

    ERIC Educational Resources Information Center

    Moss, Glenda

    2008-01-01

    This article addresses the dilemma of promoting critical pedagogy within portfolio assessment, which has been implemented in many teacher education programs to meet state and national mandates for performance-based assessment. It explores how one teacher educator works to move portfolio assessment to a level of critical self-reflection that…

  19. Payers' Views of the Changes Arising through the Possible Adoption of Adaptive Pathways.

    PubMed

    Ermisch, Michael; Bucsics, Anna; Vella Bonanno, Patricia; Arickx, Francis; Bybau, Alexander; Bochenek, Tomasz; van de Casteele, Marc; Diogene, Eduardo; Fürst, Jurij; Garuolienė, Kristina; van der Graaff, Martin; Gulbinovič, Jolanta; Haycox, Alan; Jones, Jan; Joppi, Roberta; Laius, Ott; Langner, Irene; Martin, Antony P; Markovic-Pekovic, Vanda; McCullagh, Laura; Magnusson, Einar; Nilsen, Ellen; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Sauermann, Robert; Schuurman, Ad; Ramos, Ricardo; Vlahovic-Palcevski, Vera; Zara, Corinne; Godman, Brian

    2016-01-01

    Payers are a major stakeholder in any considerations and initiatives concerning adaptive licensing of new medicinal products, also referred to as Medicines Adaptive Pathways to patients (MAPPs). Firstly, the scope and necessity of MAPPs need further scrutiny, especially with regard to the definition of unmet need. Conditional approval pathways already exist for new medicines for seriously debilitating or life-threatening diseases and only a limited number of new medicines are innovative. Secondly, MAPPs will result in new medicines on the market with limited evidence about their effectiveness and safety. Additional data are to be collected after approval. Consequently, adaptive pathways may increase the risk of exposing patients to ineffective or unsafe medicines. We have already seen medicines approved conventionally that subsequently proved ineffective or unsafe amongst a wider, more co-morbid population as well as medicines that could have been considered for approval under MAPPs but subsequently proved ineffective or unsafe in Phase III trials and were never licensed. Thirdly, MAPPs also put high demands on payers. Routine collection of patient level data is difficult with high transaction costs. It is not clear who will fund these. Other challenges for payers include shifts in the risk governance framework, implications for evaluation and HTA, increased complexity of setting prices, difficulty with ensuring equity in the allocation of resources, definition of responsibility and liability and implementation of stratified use. Exit strategies also need to be agreed in advance, including price reductions, rebates, or reimbursement withdrawals when price premiums are not justified. These issues and concerns will be discussed in detail including potential ways forward.

  20. Risk sharing arrangements for pharmaceuticals: potential considerations and recommendations for European payers

    PubMed Central

    2010-01-01

    Background There has been an increase in 'risk sharing' schemes for pharmaceuticals between healthcare institutions and pharmaceutical companies in Europe in recent years as an additional approach to provide continued comprehensive and equitable healthcare. There is though confusion surrounding the terminology as well as concerns with existing schemes. Methods Aliterature review was undertaken to identify existing schemes supplemented with additional internal documents or web-based references known to the authors. This was combined with the extensive knowledge of health authority personnel from 14 different countries and locations involved with these schemes. Results and discussion A large number of 'risk sharing' schemes with pharmaceuticals are in existence incorporating both financial-based models and performance-based/outcomes-based models. In view of this, a new logical definition is proposed. This is "risk sharing' schemes should be considered as agreements concluded by payers and pharmaceutical companies to diminish the impact on payers' budgets for new and existing schemes brought about by uncertainty and/or the need to work within finite budgets". There are a number of concerns with existing schemes. These include potentially high administration costs, lack of transparency, conflicts of interest, and whether health authorities will end up funding an appreciable proportion of a new drug's development costs. In addition, there is a paucity of published evaluations of existing schemes with pharmaceuticals. Conclusion We believe there are only a limited number of situations where 'risk sharing' schemes should be considered as well as factors that should be considered by payers in advance of implementation. This includes their objective, appropriateness, the availability of competent staff to fully evaluate proposed schemes as well as access to IT support. This also includes whether systematic evaluations have been built into proposed schemes. PMID:20529296

  1. Payers' Views of the Changes Arising through the Possible Adoption of Adaptive Pathways

    PubMed Central

    Ermisch, Michael; Bucsics, Anna; Vella Bonanno, Patricia; Arickx, Francis; Bybau, Alexander; Bochenek, Tomasz; van de Casteele, Marc; Diogene, Eduardo; Fürst, Jurij; Garuolienė, Kristina; van der Graaff, Martin; Gulbinovič, Jolanta; Haycox, Alan; Jones, Jan; Joppi, Roberta; Laius, Ott; Langner, Irene; Martin, Antony P.; Markovic-Pekovic, Vanda; McCullagh, Laura; Magnusson, Einar; Nilsen, Ellen; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Sauermann, Robert; Schuurman, Ad; Ramos, Ricardo; Vlahovic-Palcevski, Vera; Zara, Corinne; Godman, Brian

    2016-01-01

    Payers are a major stakeholder in any considerations and initiatives concerning adaptive licensing of new medicinal products, also referred to as Medicines Adaptive Pathways to patients (MAPPs). Firstly, the scope and necessity of MAPPs need further scrutiny, especially with regard to the definition of unmet need. Conditional approval pathways already exist for new medicines for seriously debilitating or life-threatening diseases and only a limited number of new medicines are innovative. Secondly, MAPPs will result in new medicines on the market with limited evidence about their effectiveness and safety. Additional data are to be collected after approval. Consequently, adaptive pathways may increase the risk of exposing patients to ineffective or unsafe medicines. We have already seen medicines approved conventionally that subsequently proved ineffective or unsafe amongst a wider, more co-morbid population as well as medicines that could have been considered for approval under MAPPs but subsequently proved ineffective or unsafe in Phase III trials and were never licensed. Thirdly, MAPPs also put high demands on payers. Routine collection of patient level data is difficult with high transaction costs. It is not clear who will fund these. Other challenges for payers include shifts in the risk governance framework, implications for evaluation and HTA, increased complexity of setting prices, difficulty with ensuring equity in the allocation of resources, definition of responsibility and liability and implementation of stratified use. Exit strategies also need to be agreed in advance, including price reductions, rebates, or reimbursement withdrawals when price premiums are not justified. These issues and concerns will be discussed in detail including potential ways forward. PMID:27733828

  2. 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.

  3. 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.

  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.

  5. The health economic impact of antidepressant usage from a payer's perspective: a multinational study.

    PubMed

    Casciano, J; Doyle, J; Arikian, S; Casciano, R

    2001-06-01

    A multinational decision analytic model was developed to examine the treatment of major depressive disorder (MDD) in 10 European and American countries. Input to the model was obtained from a meta-analysis of current clinical trial data obtained from the published literature, and local clinical and health economic experts in each market. The patient- and policy-level impact of MDD treatment was measured in each of the 10 markets. The total expected cost per patient for treating MDD with venlafaxine XR during the six-month acute phase of MDD was the lowest expected cost in nine of the 10 countries studied, resulting in savings to the primary payer in almost all markets. As well as the cost savings, the higher efficacy and lower rate of dropout found for venlafaxine XR translate to a greater number of symptom-free-days (SFDs) per patient. The results of this investigation show that use of venlafaxine XR in most settings across Europe and the Americas will have a favourable impact on healthcare payer budgets and the overall mental health of MDD patients.

  6. The effect of third-party payers on the clinical decision making of physical therapists.

    PubMed

    Uili, R M; Wood, R

    1995-04-01

    According to Freidson, third-party payers have eroded the political and economic authority of medicine. To what extent is this also true for alternative practitioners such as physical therapists? The effect of Medicare's restrictive guidelines on physical therapy practice in skilled nursing facilities (SNFs) is examined. SNF physical therapists in Connecticut were surveyed (response rate 99%) using a mixture of open-ended and fixed-alternative responses. Results indicate that SNF physical therapists recognize Medicare criteria and view them as important. Twenty-five to 33% of SNF therapists recommend care based on the guidelines. Younger therapists, therapists with fewer years in the field, and contract therapists are more greatly influenced by the guidelines than older, more experienced, staff therapists (P < 0.08). Those who recommend care based on the guidelines may do so because of possible nonpayment for services already rendered, or because they fear loss of their positions. The majority of Connecticut SNF patients who qualify do receive therapy and Medicare coverage. Therapists may use their knowledge of the guidelines to secure services for their patients, or SNFs may be selecting patients that have the best chances for recovery. Like physicians, SNF physical therapists are under pressure from third-party payers to economize and rationalize, but most continue to secure services for their patients.

  7. 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.

  8. Competing values in serving older and vulnerable adults: adult protective services, mandated reporting, and domestic violence programs.

    PubMed

    Cramer, Elizabeth P; Brady, Shane R

    2013-01-01

    State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.

  9. 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…

  10. 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

  11. 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)

  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.

  13. Using Certification to Promote Uptake of Real-World Evidence by Payers.

    PubMed

    Segal, Jodi B; Kallich, Joel D; Oppenheim, Emma R; Garrison, Louis P; Iqbal, Sheikh Usman; Kessler, Marla; Alexander, G Caleb

    2016-03-01

    Most randomized controlled trials are unable to generate information about a product's real-world effectiveness. Therefore, payers use real-world evidence (RWE) generated in observational studies to make decisions regarding formulary inclusion and coverage. While some payers generate their own RWE, most cautiously rely on RWE produced by manufacturers who have a strong financial interest in obtaining coverage for their products. We propose a process by which an independent body would certify observational studies as generating valid and unbiased estimates of the effectiveness of the intervention under consideration. This proposed process includes (a) establishing transparent criteria for assessment, (b) implementing a process for receipt and review of observational study protocols from interested parties, (c) reviewing the submitted protocol and requesting any necessary revisions, (d) reviewing the study results, (e) assigning a certification status to the submitted evidence, and (f) communicating the certification status to all who seek to use this evidence for decision making. Accrediting organizations such as the National Center for Quality Assurance and the Joint Commission have comparable goals of providing assurance about quality to those who look to their accreditation results. Although we recognize potential barriers, including a slowing of evidence generation and costs, we anticipate that processes can be streamlined, such as when familiar methods or familiar datasets are used. The financial backing for such activities remains uncertain, as does identification of organizations that might serve this certification function. We suggest that the rigor and transparency that will be required with such a process, and the unassailable evidence that it will produce, will be valuable to decision makers.

  14. 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.

  15. Evaluating Healthcare Claims for Neurocysticercosis by Using All-Payer All-Claims Data, Oregon, 2010–2013

    PubMed Central

    O’Neal, Seth E.; Townes, John M.

    2016-01-01

    To characterize the frequency of neurocysticercosis, associated diagnostic codes, and place of infection, we searched Oregon’s All Payer All-Claims dataset for 2010–2013. Twice as many cases were found by searching inpatient and outpatient data than by inpatient data alone. Studies relying exclusively on inpatient data underestimate frequency and miss less severe disease. PMID:27869593

  16. 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

  17. A mandate for nursing education leadership: change.

    PubMed

    Booth, R Z

    1994-01-01

    Changes occurring in both the internal and external environments are causing the role of the nurse education executive to undergo a major revolution. Health care reform, and numerous other events in society, are causing organizations, corporations, and states to experience an unprecedented rate of change to redesign administrative and work group structures and functions, and to realign decision making. Because of the complexity and magnitude of change, it is imperative that faculty and administration design the work of the organization to prevent duplication of effort and be active, innovative, and creative in their respective areas of responsibility. The nurse education executive's challenge is to be prepared to lead change and to manage rapid change in an ambiguous and flexible environment.

  18. Contradicting fears, California's nurse-to-patient mandate did not reduce the skill level of the nursing workforce in hospitals.

    PubMed

    McHugh, Matthew D; Kelly, Lesly A; Sloane, Douglas M; Aiken, Linda H

    2011-07-01

    When California passed a law in 1999 establishing minimum nurse-to-patient staffing ratios for hospitals, it was feared that hospitals might respond by disproportionately hiring lower-skill licensed vocational nurses. This article examines nurse staffing ratios for California hospitals for the period 1997-2008. It compares staffing levels to those in similar hospitals in the United States. We found that California's mandate did not reduce the nurse workforce skill level as feared. Instead, California hospitals on average followed the trend of hospitals nationally by increasing their nursing skill mix, and they primarily used more highly skilled registered nurses to meet the staffing mandate. In addition, we found that the staffing mandate resulted in roughly an additional half-hour of nursing per adjusted patient day beyond what would have been expected in the absence of the policy. Policy makers in other states can look to California's experience when considering similar approaches to improving patient care.

  19. Staffing changes before and after mandated nurse-to-patient ratios in California's hospitals.

    PubMed

    Serratt, Teresa; Harrington, Charlene; Spetz, Joanne; Blegen, Mary

    2011-08-01

    California is the first state to mandate specific nurse-to-patient ratios in general acute care hospitals. These ratios went into effect January 1, 2004 and apply "at all times". Little is known about the changes in staffing that occurred subsequent to the implementation of this legislation. This study identifies and describes changes in nurse and non-nursing staffing that may have occurred as a result of the enactment of these nurse-to-patient ratios. The results of this study indicate that most hospitals made upward adjustments in their RN and registry nurse staff but decreases in support staff and other non-nurse staff were not evident. These findings suggest that these mandated ratios had the desired effect of increasing the number of nurses caring for acutely ill patients.

  20. 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

  1. Stepped Care for Mandated College Students: A Pilot Study

    PubMed Central

    Borsari, Brian; O’Leary Tevyaw, Tracy; Barnett, Nancy P.; Kahler, Christopher W.; Monti, Peter M.

    2009-01-01

    In the past decade, colleges and universities have seen a large increase in the number of students referred for the violation of alcohol policies. Stepped care assigns individuals to different levels of care according to treatment response, thereby maximizing efficiency. This pilot study implemented stepped care with students mandated to attend an alcohol program at a private northeastern university. High retention rates and participant satisfaction ratings suggest the promise of implementing stepped care with this population. Considerations for future applications of stepped care with mandated students are discussed. PMID:17453615

  2. Implementation of cancer clinical care pathways: s successful model of collaboration between payers and providers.

    PubMed

    Feinberg, Bruce A; Lang, James; Grzegorczyk, James; Stark, Donna; Rybarczyk, Thomas; Leyden, Thomas; Cooper, Joseph; Ruane, Thomas; Milligan, Scott; Stella, Phillip; Scott, Jeffrey A

    2012-05-01

    Despite rising medical costs within the US healthcare system, quality and outcomes are not improving. Without significant policy reform, the cost-quality imbalance will reach unsustainable proportions in the foreseeable future. The rising cost of healthcare in part results from an expanding aging population with an increasing number of life-threatening diseases. This is further compounded by a growing arsenal of high-cost therapies. In no medical specialty is this more apparent than in the area of oncology. Numerous attempts to reduce costs have been attempted, often with limited benefit and brief duration. Because physicians directly or indirectly control or influence the majority of medical care costs, physician behavioral changes must occur to bend the healthcare cost curve in a sustainable fashion. Experts within academia, health policy, and business agree that a significant paradigm change in stakeholder collaboration will be necessary to accomplish behavioral change. Such a collaboration has been pioneered by Blue Cross Blue Shield of Michigan and Physician Resource Management, a highly specialized oncology healthcare consulting firm with developmental and ongoing technical, analytic, and consultative support from Cardinal Health Specialty Solutions, a division of Cardinal Health. We describe a successful statewide collaboration between payers and providers to create a cancer clinical care pathways program. We show that aligned stakeholder incentives can drive high levels of provider participation and compliance in the pathways that lead to physician behavioral changes. In addition, claims-based data can be collected, analyzed, and used to create and maintain such a program.

  3. Implementation of cancer clinical care pathways: a successful model of collaboration between payers and providers.

    PubMed

    Feinberg, Bruce A; Lang, James; Grzegorczyk, James; Stark, Donna; Rybarczyk, Thomas; Leyden, Thomas; Cooper, Joseph; Ruane, Thomas; Milligan, Scott; Stella, Philip; Scott, Jeffrey A

    2012-05-01

    Despite rising medical costs within the US health care system, quality and outcomes are not improving. Without significant policy reform, the cost-quality imbalance will reach unsustainable proportions in the foreseeable future. The rising cost of health care in part results from an expanding aging population with an increasing number of life-threatening diseases. This is further compounded by a growing arsenal of high-cost therapies. In no medical specialty is this more apparent than in the area of oncology. Numerous attempts to reduce costs have been attempted, often with limited benefit and brief duration. Because physicians directly or indirectly control or influence the majority of medical care costs, physician behavioral changes must occur to bend the health care cost curve in a sustainable fashion. Experts within academia, health policy, and business agree that a significant paradigm change in stakeholder collaboration will be necessary to accomplish behavioral change. Such a collaboration has been pioneered by Blue Cross Blue Shield of Michigan and Physician Resource Management, a highly specialized oncology health care consulting firm with developmental and ongoing technical, analytic, and consultative support from Cardinal Health Specialty Solutions, a division of Cardinal Health. We describe a successful statewide collaboration between payers and providers to create a cancer clinical care pathways program. We show that aligned stakeholder incentives can drive high levels of provider participation and compliance in the pathways that lead to physician behavioral changes. In addition, claims-based data can be collected, analyzed, and used to create and maintain such a program.

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. Economic Evaluation of PCSK9 Inhibitors in Reducing Cardiovascular Risk from Health System and Private Payer Perspectives

    PubMed Central

    Page, Timothy F.; Veledar, Emir; Nasir, Khurram

    2017-01-01

    The introduction of Proprotein covertase subtilisin/kexin type 9 (PCSK9) inhibitors has been heralded as a major advancement in reducing low-density lipoprotein cholesterol levels by nearly 50%. However, concerns have been raised on the added value to the health care system in terms of their costs and benefits. We assess the cost-effectiveness of PCSK9 inhibitors based on a decision-analytic model with existing clinical evidence. The model compares a lipid-lowering therapy based on statin plus PCSK9 inhibitor treatment with statin treatment only (standard therapy). From health system perspective, incremental cost per quality adjusted life years (QALYs) gained are presented. From a private payer perspective, return-on-investment and net present values over patient lifespan are presented. At the current annual cost of $14,000 to $15,000, PCSK9 inhibitors are not cost-effective at an incremental cost of about $350,000 per QALY. Moreover, for every dollar invested in PCSK9 inhibitors, the private payer loses $1.98. Our study suggests that the annual treatment price should be set at $4,250 at a societal willingness-to-pay of $100,000 per QALY. However, we estimate the breakeven price for private payer is only $600 per annual treatment. At current prices, our study suggests that PCSK9 inhibitors do not add value to the U.S. health system and their provision is not profitable for private payers. To be the breakthrough drug in the fight against cardiovascular disease, the current price of PCSK9 inhibitors must be reduced by more than 70%. PMID:28081164

  10. Financial implications of a model heart failure disease management program for providers, hospital, healthcare systems, and payer perspectives.

    PubMed

    Whellan, David J; Reed, Shelby D; Liao, Lawrence; Gould, Stuart D; O'connor, Christopher M; Schulman, Kevin A

    2007-01-15

    Although heart failure disease management (HFDM) programs improve patient outcomes, the implementation of these programs has been limited because of financial barriers. We undertook the present study to understand the economic incentives and disincentives for adoption of disease management strategies from the perspectives of a physician (group), a hospital, an integrated health system, and a third-party payer. Using the combined results of a group of randomized controlled trials and a set of financial assumptions from a single academic medical center, a financial model was developed to compute the expected costs before and after the implementation of a HFDM program by 3 provider types (physicians, hospitals, and health systems), as well as the costs incurred from a payer perspective. The base-case model showed that implementation of HFDM results in a net financial loss to all potential providers of HFDM. Implementation of HFDM as described in our base-case analysis would create a net loss of US dollars 179,549 in the first year for a physician practice, US dollars 464,132 for an integrated health system, and US dollars 652,643 in the first year for a hospital. Third-party payers would be able to save US dollars 713,661 annually for the care of 350 patients with heart failure in a HFDM program. In conclusion, although HFDM programs may provide patients with improved clinical outcomes and decreased hospitalizations that save third-party payers money, limited financial incentives are currently in place for healthcare providers and hospitals to initiate these programs.

  11. 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

  12. 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…

  13. 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…

  14. Brief Alcohol Interventions With Mandated or Adjudicated College Students

    PubMed Central

    Barnett, Nancy P.; Tevyaw, Tracy O’Leary; Fromme, Kim; Borsari, Brian; Carey, Kate B.; Corbin, William R.; Colby, Suzanne M.; Monti, Peter M.

    2009-01-01

    This article summarizes the proceedings of a symposium presented at the 2003 RSA Meeting in Ft. Lauderdale, Florida, organized and chaired by Nancy Barnett. The purpose of the symposium was to present information and efficacy data about approaches to brief intervention with students who get into trouble on their campuses for alcohol and as a result are required to attend alcohol education or counseling. Presentations were (1) Differences Between Mandated College Students and Their Peers on Alcohol Use and Readiness to Change, by Tracy O’Leary Tevyaw; (2) An Effective Alcohol Prevention Program for Mandated College Students, by Kim Fromme; (3) Two Brief Alcohol Interventions for a Referred College Population, by Kate Carey; and (4) Brief Motivational Intervention With College Students Following Medical Treatment or Discipline for Alcohol, by Nancy Barnett. The data presented in this symposium indicated that students who are evaluated or disciplined for alcohol use are on average heavy drinkers who drink more heavily than their closest peers. Brief intervention approaches described by the speakers included group classroom sessions, individual motivational intervention, individual alcohol education, and computerized alcohol education. Reductions in consumption and problems were noted across the various intervention groups. Brief motivational intervention as a general approach with mandated students shows promise in that it reduced alcohol problems in a group of mandated students who were screened for being at risk (in the Borsari and Carey study) and increased the likelihood that students would attend further counseling (in the Barnett study). PMID:15218881

  15. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 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...

  16. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 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...

  17. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 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...

  18. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 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...

  19. 10 CFR 490.202 - Acquisitions satisfying the mandate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Acquisitions satisfying the mandate. 490.202 Section 490.202 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...

  20. 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…

  1. 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…

  2. 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,…

  3. Education Policy Mediation: Principals' Work with Mandated Literacy Assessment

    ERIC Educational Resources Information Center

    Comber, Barbara; Cormack, Phil

    2011-01-01

    Mandated literacy assessment is now a ubiquitous practice in many western educational systems. While educational researchers, principals, teachers and education unions continue to offer vociferous resistance in some nations, in others it is now commonplace in the educational landscape and built into the rhythms of the school year. This paper is…

  4. 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…

  5. 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…

  6. 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.

  7. Anger Disturbances among Perpetrators of Intimate Partner Violence: Clinical Characteristics and Outcomes of Court-Mandated Treatment

    ERIC Educational Resources Information Center

    Eckhardt, Christopher I.; Samper, Rita E.; Murphy, Christopher M.

    2008-01-01

    In the present study, the authors clustered a pretreatment sample of 190 perpetrators of intimate partner violence (IPV) mandated to attend group counseling based on State-Trait Anger Expression Inventory scores and examined whether these profiles were associated with differential outcomes 1 year postadjudication. Cluster analysis revealed 3…

  8. 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…

  9. Considerations for payers in managing hormone receptor-positive advanced breast cancer

    PubMed Central

    Chitre, Mona; Reimers, Kristen M

    2014-01-01

    Breast cancer (BC) is the second most common cause of death in women. In 2010, the direct cost associated with BC care in the US was $16.5 billion, the highest among all cancers. By the year 2020, at the current rates of incidence and survival, the cost is projected to increase to approximately $20 billion. Although endocrine therapies to manage hormone receptor-positive (HR+) BC are highly effective, endocrine resistance results in disease progression. Increased understanding of endocrine resistance and the mechanisms of disease progression has led to development and subsequent approval of novel targeted treatments, resulting in the expansion of the therapeutic armamentarium to combat HR+ BC. Clear guidelines based on the safety and efficacy of treatment options exist; however, the optimal sequence of therapy is unknown, and providers, payers, and other key players in the health care system are tasked with identifying cost-effective and evidence-based treatment strategies that will improve patient outcomes and, in time, help curb the staggering increase in cost associated with BC care. Safety and efficacy are key considerations, but there is also a need to consider the impact of a given therapy on patient quality of life, treatment adherence, and productivity. To minimize cost associated with overall management, cost-effectiveness, and financial burden that the therapy can impose on patients, caregivers and managed care plans are also important considerations. To help evaluate and identify the optimal choice of therapy for patients with HR+ advanced BC, the available data on endocrine therapies and novel agents are discussed, specifically with respect to the safety, efficacy, financial impact on patients and the managed care plan, impact on quality of life and productivity of patients, and improvement in patient medication adherence. PMID:25031542

  10. The Association of Adolescent Depressive Symptoms with Healthcare Utilization and Payer-Incurred Expenditures

    PubMed Central

    Wright, Davene R.; Katon, Wayne J.; Ludman, Evette; McCauley, Elizabeth; Oliver, Malia; Lindenbaum, Jeffrey; Richardson, Laura P.

    2015-01-01

    Objective Screening adolescents for depression is recommended by the U.S. Preventive Services Task Force. We sought to evaluate the impact of positive depression screens in an adolescent population on healthcare utilization and costs from a payer perspective. Methods We conducted depression screening among 13-17 year olds adolescents enrolled in a large integrated care system using the 2- and 9-item Patient Health Questionnaires (PHQ). Healthcare utilization and cost data were obtained from administrative records. Chi-square, Wilcoxon rank-sum, and t-tests were used to test for statistical differences in outcomes between adolescents based on screening status. Results Of the 4,010 adolescents who completed depression screening, 3,707 (92.4%) screened negative (PHQ-2 < 2 or PHQ-9 < 10), 186 (3.9%) screened positive for mild depression (PHQ-9 = 10-14), and 95 (2.4%) screened positive for moderate-to-severe depression (PHQ-9 ≥ 15). In the 12-months after screening, screen-positive adolescents were more likely than screen-negative adolescents to receive any emergency department visit or inpatient hospitalization, and had significantly higher utilization of outpatient medical (mean (SD) = 8.3 (1.5) vs. 3.5 (5.1)) and mental health (3.8 (9.3) vs. 0.7 (3.5)) visits. Mean total healthcare system costs for screen-positive adolescents ($5,083 ($10,489)) were more than twice as high as those of screen-negative adolescents ($2,357 ($7,621)). Conclusion Adolescent depressive symptoms, even when mild, are associated with increased healthcare utilization and costs. Only a minority of the increased costs is attributable to mental health care. Implementing depression screening and evidence-based mental health services may help to better control healthcare costs among screen-positive adolescents. PMID:26456002

  11. 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.

  12. 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

  13. What Color Helmet? Reforming Security Council Peacekeeping Mandates

    DTIC Science & Technology

    1997-08-01

    Security Council mandate may meet the procedural, but not the substantive, requirements of the Charter. Article 2(7) finishes by providing that...established in June 1 99 1 , continues through UNAVEM II I . When UNAVEM I finishe d, Angola requested assistance from the United Nations in implementing...on 27 and 28 October 1 994 . ONUMOZ’s peacekeeping operations actually finished in January 1 995 . 29. UNOSOM I I . The original UN Operation in

  14. 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

  15. The effect of methodology in determining disparities in in-hospital mortality of trauma patients based on payer source.

    PubMed

    Berg, Gina M; Lee, Felecia A; Hervey, Ashley M; Hines, Robert B; Basham-Saif, Angela; Harrison, Paul B

    2015-01-01

    A retrospective registry review of adult patients admitted to a Level I trauma center sought to determine whether results regarding in-hospital mortality associated with payer source vary on the basis of methodology. Patients were categorized into 4 literature-derived definitions (Definition 1: insured and uninsured; Definition 2: commercially insured, publicly insured, and uninsured; Definition 3: commercially insured, Medicaid, Medicare, and uninsured; and Definition 4: commercially insured, Medicaid, and uninsured). In-hospital mortality differences were found in Definitions 2 and 3, and when reclassifying dual-eligible Medicare/Medicaid into socioeconomic and age indicators. Variations in methodology culminated in results that could be interpreted with differing conclusions.

  16. 77 FR 59629 - Statutorily Mandated Designation of Difficult Development Areas for 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... URBAN DEVELOPMENT Statutorily Mandated Designation of Difficult Development Areas for 2013 AGENCY... notice designates ``Difficult Development Areas'' (DDAs) for purposes of the Low-Income Housing Tax... ``Statutorily Mandated Designation of Difficult Development Areas and Qualified Census Tracts for...

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Payer-provider collaboration in accountable care reduced use and improved quality in Maine Medicare Advantage plan.

    PubMed

    Claffey, Thomas F; Agostini, Joseph V; Collet, Elizabeth N; Reisman, Lonny; Krakauer, Randall

    2012-09-01

    Patient-centered, accountable care has garnered increased attention with the passage of the Affordable Care Act and new Medicare regulations. This case study examines a care model jointly developed by a provider and a payer that approximates an accountable care organization for a Medicare Advantage population. The collaboration between Aetna and NovaHealth, an independent physician association based in Portland, Maine, focused on shared data, financial incentives, and care management to improve health outcomes for approximately 750 Medicare Advantage members. The patient population in the pilot program had 50 percent fewer hospital days per 1,000 patients, 45 percent fewer admissions, and 56 percent fewer readmissions than statewide unmanaged Medicare populations. NovaHealth's total per member per month costs across all cost categories for its Aetna Medicare Advantage members were 16.5 percent to 33 percent lower than costs for members not in this provider organization. Clinical quality metrics for diabetes, ischemic vascular disease, annual office visits, and postdischarge follow-up for patients in the program were consistently high. The experience of developing and implementing this collaborative care model suggests that several components are key, including robust data sharing and information systems that support it, analytical support, care management and coordination, and joint strategic planning with close provider-payer collaboration.

  3. 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.

  4. Does mandating offenders to treatment improve completion rates?

    PubMed

    Coviello, Donna M; Zanis, Dave A; Wesnoski, Susan A; Palman, Nicole; Gur, Arona; Lynch, Kevin G; McKay, James R

    2013-04-01

    While it is known that community-based outpatient treatment for substance abusing offenders is effective, treatment completion rates are low and much of the prior research has been conducted with offenders in residential treatment or therapeutic communities. The aim of the present study was to assess whether offenders who are mandated to community-based outpatient treatment have better completion rates compared to those who enter treatment voluntarily. The 160 research participants were a heterogeneous group of substance abusers who were under various levels of criminal justice supervision (CJS) in the community. The participants were enrolled in an intensive outpatient program and were recruited into the study between July 2007 and October 2010. All offenders received weekly therapy sessions using a cognitive problem solving framework and 45% completed the 6 month treatment program. Interestingly, those who were mandated demonstrated less motivation at treatment entry, yet were more likely to complete treatment compared to those who were not court-ordered to treatment. While controlling for covariates known to be related to treatment completion, the logistic regression analyses demonstrated that court-ordered offenders were over 10 times more likely to complete treatment compared to those who entered treatment voluntarily (OR=10.9, CI=2.0-59.1, p=.006). These findings demonstrate that stipulated treatment for offenders may be an effective way to increase treatment compliance.

  5. Impact of California mandated acute care hospital nurse staffing ratios: a literature synthesis.

    PubMed

    Donaldson, Nancy; Shapiro, Susan

    2010-08-01

    California is the first state to enact legislation mandating minimum nurse-to-patient ratios at all times in acute care hospitals. This synthesis examines 12 studies of the impact of California's ratios on patient care cost, quality, and outcomes in acute care hospitals. A key finding from this synthesis is that the implementation of minimum nurse-to-patient ratios reduced the number of patients per licensed nurse and increased the number of worked nursing hours per patient day in hospitals. Another finding is that there were no significant impacts of these improved staffing measures on measures of nursing quality and patient safety indicators across hospitals. A critical observation may be that adverse outcomes did not increase despite the increasing patient severity reflected in case mix index. We cautiously posit that this finding may actually suggest an impact of ratios in preventing adverse events in the presence of increased patient risk.

  6. Congress, courts, and commerce: upholding the individual mandate to protect the public's health.

    PubMed

    Hodge, James G; Brown, Erin C Fuse; Orenstein, Daniel G; O'Keefe, Sarah

    2011-01-01

    Among multiple legal challenges to the Patient Protection and Affordable Care Act (PPACA) is the premise that PPACA's "individual mandate" (requiring all individuals to obtain health insurance by 2014 or face civil penalties) is inviolate of Congress' interstate commerce powers because Congress lacks the power to regulate commercial "inactivity." Several courts initially considering this argument have rejected it, but federal district courts in Virginia and Florida have concurred, leading to numerous appeals and prospective review of the United States Supreme Court. Despite creative arguments, the dispositive constitutional question is not whether Congress' interstate commerce power extends to commercial inactivity. Rather, it is whether Congress may regulate individual decisions with significant economic ramifications in the interests of protecting and promoting the public's health. This article offers a counter-interpretation of the scope of Congress' interstate commerce power to regulate in furtherance of the public's health.

  7. Supporting the advancement of science: open access publishing and the role of mandates.

    PubMed

    Phelps, Lisa; Fox, Bernard A; Marincola, Francesco M

    2012-01-24

    In December 2011 the United States House of Representatives introduced a new bill, the Research Works Act (H.R.3699), which if passed could threaten the public's access to US government funded research. In a digital age when professional and lay parties alike look more and more to the online environment to keep up to date with developments in their fields, does this bill serve the best interests of the community? Those in support of the Research Works Act argue that government open access mandates undermine peer-review and take intellectual property from publishers without compensation, however journals like Journal of Translational Medicine show that this is not the case. Journal of Translational Medicine in affiliation with the Society for Immunotherapy of Cancer demonstrates how private and public organisations can work together for the advancement of science.

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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…

  14. Compliance with PL94-142 Mandates: Implications for Rural Teacher Training Programs.

    ERIC Educational Resources Information Center

    Silver, Sandra

    1987-01-01

    Study examines implications for rural special education cooperatives of federal law mandating education for handicapped children. Compliance was assessed in 135 cooperatives in Regions 4 and 5. Mandated parental rights, student assessments, and individual plans posed least difficulty. Lack of special education knowledge posed most difficulty.…

  15. Can Nightmares Become Sweet Dreams? Peer Review in the Wake of a Systemwide Administrative Mandate.

    ERIC Educational Resources Information Center

    Langsam, Deborah M.; Dubois, Philip L.

    1996-01-01

    In 1993, the University of North Carolina at Charlotte's governing board mandated peer evaluation for nontenured faculty. Participants in the American Association for Higher Education's peer review project feared the mandate would taint efforts to introduce faculty to collegial approaches to peer review. However, negative fallout from the mandate…

  16. Professional Lives of Teacher Educators in an Era of Mandated Reform

    ERIC Educational Resources Information Center

    Turley, Steve

    2005-01-01

    The purpose of this article is to reflect on the conditions teacher educators labor under as they go about their professional lives in the overheated climate of mandated education reform of recent years, particularly when the mandates are multiple, have strict timeliness, and carry high-stakes consequences. The article focuses on faculty…

  17. Evaluation of Web-Based and Counselor-Delivered Feedback Interventions for Mandated College Students

    ERIC Educational Resources Information Center

    Doumas, Diana M.; Workman, Camille R.; Navarro, Anabel; Smith, Diana

    2011-01-01

    This study evaluated the efficacy of 2 brief personalized feedback interventions aimed at reducing drinking among mandated college students. Results indicated significant reductions in drinking for students in both conditions. Findings provide support for web-based interventions for mandated college students. (Contains 1 table.)

  18. 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

  19. Budgetary Impact of Treating Acute Promyelocytic Leukemia Patients with First-Line Arsenic Trioxide and Retinoic Acid from an Italian Payer Perspective

    PubMed Central

    Kruse, Morgan; Wildner, Rebecca; Barnes, Gisoo; Martin, Monique; Mueller, Udo; Lo-Coco, Francesco; Pathak, Ashutosh

    2015-01-01

    The objective of this study was to estimate the net cost of arsenic trioxide (ATO) added to all-trans retinoic acid (ATRA) compared to ATRA plus chemotherapy when used in first-line acute promyelocytic leukemia (APL) treatment for low to intermediate risk patients from the perspective of the overall Italian healthcare systemA Markov model was developed with 3 health states: stable disease, disease event and death. Each month, patients could move from stable to disease event or die from either state. After a disease event, patients discontinued initial treatment and switched to the other regimen as second-line therapy. Treatment regimens, efficacy and adverse events were derived from published sources and expert opinion; unit costs were collected from standard Italian sources. Clinical outcomes and costs for pre-ATO and post-ATO scenarios were combined with population and product utilization information to calculate the total budgetary impact using a 3-year time horizon; one-way sensitivity analyses were conducted. Three-year cumulative pharmacy costs for ATO+ATRA were €46,700 per-patient versus €6,500 for ATRA+chemotherapy; however, medical costs for ATO+ATRA were €12,300 per-patient versus €30,200 for ATRA+chemotherapy. The total budgetary impact was estimated to be an additional €127,300, €312,500 and €477,800 in the first, second and third years, respectively. The model was most sensitive to changes in the cost of the ATO+ATRA regimen during the consolidation phase. Budgetary impact models are valuable to payers making formulary decisions regarding the access and affordability of new medicines. The cost of treatment analysis showed that pharmacy costs for ATO+ATRA were higher than for ATRA+chemotherapy, while all other evaluated costs were lower for ATO+ATRA treated patients. The average budgetary impact was €305,900 per year overall, representing a 3.5% increase. Further research is needed to determine the cost-effectiveness of ATO+ATRA compared

  20. Engaging primary care physicians in quality improvement: lessons from a payer-provider partnership.

    PubMed

    Lemak, Christy Harris; Cohen, Genna R; Erb, Natalie

    2013-01-01

    A health insurer in Michigan, through its Physician Group Incentive Program, engaged providers across the state in a collection of financially incentivized initiatives to transform primary care and improve quality. We investigated physicians' and other program stakeholders' perceptions of the program through semistructured interviews with more than 80 individuals. We found that activities across five areas contributed to successful provider engagement: (1) developing a vision of improving primary care, (2) deliberately fostering practice-practice partnerships, (3) using existing infrastructure, (4) leveraging resources and market share, and (5) managing program trade-offs. Our research highlights effective strategies for engaging primary care physicians in program design and implementation processes and creating learning communities to support quality improvement and practice change.

  1. Effect of insurance payer status on the surgical treatment of early stage breast cancer: data analysis from a single health system.

    PubMed

    Adepoju, Linda; Wanjiku, Stephen; Brown, Megan; Qu, Weikai; Williams, Mallory; Redfern, Roberta E; Sferra, Joseph J

    2013-06-01

    The effect of insurance payer status on surgical treatment of early stage breast cancer is unclear. This retrospective study examined the effect of insurance payer on mastectomy rates of 1539 women treated within a single health system. Women with Medicaid had significantly larger tumors compared with those with private insurance (PI) at diagnosis (3.3 cm vs 2.1 cm, P < .05) and were more likely to be treated with mastectomy for larger tumors compared with women with PI. However, women with PI were more likely to have mastectomy for smaller tumors; among women with tumors less than 2 cm, 11% with Medicaid underwent mastectomy compared with 47% with PI (P < .05). Overall, when compared with those with PI, women with Medicaid were more likely to receive mastectomy (60% vs 39%, P < .05).

  2. Primary Payer Status is Associated with the Use of Nerve Block Placement for Ambulatory Orthopedic Surgery

    PubMed Central

    Tighe, Patrick J.; Brennan, Meghan; Moser, M.; Boezaart, Andre P.; Bihorac, Azra

    2012-01-01

    Introduction Although more than 30 million patients in the United States undergo ambulatory surgery each year, it remains unclear what percentage of these patients receive a perioperative nerve block. We reviewed data from the 2006 National Survey of Ambulatory Surgery (NSAS) to determine the demographic, socioeconomic, geographic, and clinical factors associated with the likelihood of nerve block placement for ambulatory orthopedic surgery. The primary outcome of interest was the association between primary method of payment and likelihood of nerve block placement. Additionally, we examined the association between type of surgical procedures, patient demographics, and hospital characteristics with the likelihood of receiving a nerve block. Methods This cross-sectional study reviewed 6,000 orthopedic anesthetics from the 2006 NSAS dataset, which accounted for over 3.9 million orthopedic anesthetics when weighted. The primary outcome of this study addressed the likelihood of receiving a nerve block for orthopedic ambulatory surgery according to the patient’s primary method of payment. Secondary endpoints included differences in demographics, surgical procedures, side effects, complications, recovery profile, anesthesia staffing model, and total perioperative charges in those with and without nerve block. Results Overall, 14.9% of anesthetics in this sample involved a peripheral nerve block. Length of time in postoperative recovery, total perioperative time, and total charges were less for those receiving nerve blocks. Patients were more likely to receive a nerve block if their procedures were performed in metropolitan service areas (OR 1.86, 95% CI 1.19-2.91, p=0.007) or freestanding surgical facilities (OR 2.27, 95% CI 1.74-2.96, p<0.0001), and if payment for their surgery was supported by government programs (OR 2.5, 95% CI 1.01-6.21, p=0.048) or private insurance (OR 2.62, 95% CI 1.12-6.13, p=0.03) versus self-pay or charity care. Conclusion For patients

  3. Incremental costs of prostate cancer trials: Are clinical trials really a burden on a public payer system?

    PubMed Central

    Jones, Britney; Syme, Rachel; Eliasziw, Misha; Eigl, Bernhard J.

    2013-01-01

    Introduction: Clinical trials are a critical component of improving cancer prevention and treatment strategies. However, the perception that patients enrolled in trials consume more resources than those receiving the standard-of-care (SOC) has contributed to an increasingly research-averse environment. Current economic data pertaining to the per-patient costs of prostate cancer trials relative to SOC treatment are limited. Methods: A retrospective observational cohort study was conducted to compare costs incurred by 59 prostate cancer patients participating in a mix of industry and non-industry sponsored clinical trials with costs incurred by an equal number of eligible non-participants who received SOC over a year. Resource utilization was tracked and quantified to standardized price templates. Results: No difference in overall resource utilization was seen between trial and SOC patients (two-tailed t-test, n = 118, p = 0.99). Variability in the types of resources used by each group indicated that, while trial patients may take up significantly more clinic time (p = 0.001) and undergo more tests and procedures (p = 0.001), SOC patients are more likely to receive other costly interventions, such as radiation therapy (p < 0.001). Other variables (e.g., pathology, diagnostic imaging, prescribed therapies) were statistically indistinguishable between groups. Conclusion: This study revealed differences in the cost distribution of patients enrolled in clinical trials versus those receiving SOC, which could be used to improve resource allocation. The lack of evidence for a difference in overall cost provides an argument for payers to more fully support clinical research without fear of adverse financial consequences. Further analysis is required. PMID:23671532

  4. Intervention defensiveness as a moderator of drinking outcome among heavy-drinking mandated college students.

    PubMed

    Palmer, Rebekka S; Kilmer, Jason R; Ball, Samuel A; Larimer, Mary E

    2010-12-01

    The efficacy of the Alcohol Skills Training Program (ASTP; Miller, et al., 2000) was evaluated in 204 heavy-drinking college students randomly assigned to either ASTP (n=119) or an assessment-only control (n=85) condition. The volunteer ASTP sample (n=119) was also compared to a sample of students mandated to ASTP following a first-time sanction (n=90). At baseline, mandated students reported lower levels of peak drinking, negative consequences, readiness to change and higher defensiveness than voluntary students. However, the voluntary sample showed reductions in problem drinking indicators over time such that there were no differences from mandated students at follow-up. There were no outcome differences between volunteers assigned to ASTP versus assessment-only. A new measure of defensiveness was evaluated and had a significant moderating effect on ASTP outcome for peak drinking consumed on a peak occasion at follow-up among mandated students.

  5. Exploring the psychological underpinnings of the moral mandate effect: motivated reasoning, group differentiation, or anger?

    PubMed

    Mullen, Elizabeth; Skitka, Linda J

    2006-04-01

    When people have strong moral convictions about outcomes, their judgments of both outcome and procedural fairness become driven more by whether outcomes support or oppose their moral mandates than by whether procedures are proper or improper (the moral mandate effect). Two studies tested 3 explanations for the moral mandate effect. In particular, people with moral mandates may (a) have a greater motivation to seek out procedural flaws when outcomes fail to support their moral point of view (the motivated reasoning hypothesis), (b) be influenced by in-group distributive biases as a result of identifying with parties that share rather than oppose their moral point of view (the group differentiation hypothesis), or (c) react with anger when outcomes are inconsistent with their moral point of view, which, in turn, colors perceptions of both outcomes and procedures (the anger hypothesis). Results support the anger hypothesis.

  6. 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...

  7. 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...

  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. 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...

  10. 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...

  11. 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

    ... 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)? Yes, Self-Governance Tribes and their employees carrying out statutorily mandated grant programs are...

  12. 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...-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...

  13. 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...

  14. 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...

  15. 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

    ... 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)? Yes, Self-Governance Tribes and their employees carrying out statutorily mandated grant programs are...

  16. 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

    ... 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)? Yes, Self-Governance Tribes and their employees carrying out statutorily mandated grant programs are...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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

    ... 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)? Yes, Self-Governance Tribes and their employees carrying out statutorily mandated grant programs are...

  2. 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...

  3. 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...

  4. 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

    ... 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)? Yes, Self-Governance Tribes and their employees carrying out statutorily mandated grant programs are...

  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. 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.

  7. Civil rights for people with disabilities: obstacles related to the least restrictive environment mandate.

    PubMed

    Palley, Elizabeth

    2009-01-01

    State and other social service agencies as well as service providers are governed by laws that often provide unclear guidance regarding the rights of people with disabilities. Although some standards can be, and have been, developed to protect the rights of people with disabilities, all people with disabilities are not the same and therefore, each can require very different types of accommodations. Some aspects of disability rights must be individually based, including the requirement that people with disabilities receive educational services in the least restrictive environment and care in the most inclusive setting. The current interpretation of these mandates suggests that agency decisions rely on professional judgments. Unless professionals work with their clients, this reliance can serve to disempower those whom the law was intended to protect. Though much debated, the legal definition of a person with a disability is unclear. This article examines the concept of disability and that of the least restrictive environment as well as that of the "most inclusive setting," explains to whom they apply, discusses how they have been defined both in statutes and case law, and elaborates on the role of social workers as a result of the law's reliance on professional judgment in ascertaining client rights.

  8. How have mandated nurse staffing ratios affected hospitals? Perspectives from California hospital leaders.

    PubMed

    Chapman, Susan A; Spetz, Joanne; Seago, Jean Ann; Kaiser, Jennifer; Dower, Catherine; Herrera, Carolina

    2009-01-01

    In 1999, California became the first state to pass legislation mandating minimum nurse-to-patient ratios. Regulations detailing specific ratios by type of hospital unit were released in 2002, with phased-in implementation beginning in 2004 and completed in 2008. These ratios were implemented at a time of severe registered nurse (RN) shortage in the state and a worsening financial position for many hospitals. This article presents an analysis of qualitative data from interviews with healthcare leaders about the impact of nurse staffing ratios. Twenty hospitals (including public, not-for-profit, and for-profit institutions) representing major geographic regions of California were approached. Twelve agreed to participate; semistructured in-person and telephone interviews were conducted with 23 hospital leaders. Several key themes emerged from the analysis. Most hospitals found it difficult and expensive to find more RNs to hire to meet the ratios. Meeting the staffing requirements on all units, at all times, was challenging and had negative impacts, such as a backlog of patients in the emergency department and a decrease of other ancillary staff. Hospital leaders do not believe that ratios have had an impact on patient quality of care. Findings related to nurse satisfaction were mixed. Increased RN staffing improved satisfaction with patient workload, but dissatisfaction with issues of decision-making control (e.g., decisions on when best to take a meal break) were taken out of the nurse's hands to meet ratio requirements. Further research should continue to monitor patient outcomes as other states consider similar ratio regulations. Results of this study will be useful to healthcare managers searching for ways to reduce unnecessary administrative costs while continuing to maintain the level of administrative activities required for the provision of safe, effective, high-quality care.

  9. 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.

  10. Mandated Class Size and Available Classrooms: An Educational Facility Dilemma.

    ERIC Educational Resources Information Center

    Lane, Kenneth E.; Prickett, R. L.

    The call for limits on the enrollment of students in classes has continued to grow during the past decade despite questions regarding whether class size really makes a difference in instructional effectiveness. The purpose of the research reported here is to establish what the states have actually done to reduce class size in kindergarten through…

  11. Public Broadcasting and the Fairness Doctrine: A Continued Mandate?

    ERIC Educational Resources Information Center

    Kleiman, Howard

    The fairness doctrine states that broadcasters must devote a reasonable amount of time covering contrasting views of public issues. The debate over abolition of the doctrine has largely ignored the possibility that public broadcast stations licensed to government entities may be subject to political and constitutional pressures that would warrant…

  12. Delaying the Employer Mandate: Small Change in the Short Term, Big Cost in the Long Run.

    PubMed

    Price, Carter C; Saltzman, Evan

    2013-01-01

    In July 2013, the Obama administration announced a one-year delay in enforcement of the Affordable Care Act's (ACA) penalty on large employers that do not offer affordable health insurance coverage. To help policymakers understand the implications of this decision, RAND analysts employed the COMPARE microsimulation model to gauge the impact of the one-year delay of the so-called employer mandate. They found that the delay will not have a large impact on insurance coverage: Because relatively few firms and employees are affected, only 300,000 fewer people, or 0.2% of the population, will have access to insurance from their employer, and nearly all of these will get insurance from another source. However, a one-year delay in implementation of the mandate will result in $11 billion dollars less in federal inflows from employer penalties for that year. A full repeal of the employer mandate would cause revenue to fall by $149 billion over the next ten years (10% of the ACA's spending offsets), providing substantially less money to pay for other components of the law. The bottom line: The one-year delay in the employer mandate will have relatively few consequences, primarily resulting in a relatively small one-year drop in revenue; however, a complete elimination of the mandate would have a large cumulative net cost, potentially removing a nontrivial revenue source that in turn funds the coverage provisions in the ACA.

  13. 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.

  14. Fuel-saving mandate drives a hard bargain for Detroit

    SciTech Connect

    Simpson, G.

    1988-09-19

    This article discusses the pros and cons of deregulation of the corporate average fuel efficiency (CAFE) program, which was developed in the 1970s as a solution to the problems of fuel shortages and rising fuel costs. The CAFE program is administered by the DOT and National Highway Traffic Safety Administration. Detroit automakers state that the CAFE program forces the decline of larger, safer cars in lieu of smaller more fuel efficient models, therefore eliminating jobs for Americans as the smaller cars are foreign-made. The automakers and several Washington lobbies want a relaxation or even elimination of these regulations as it will increase jobs in America, increase safety, and encourage competition in the larger car markets, as the regulations drive the cost to produce larger cars up. The opponents to the easing of standards want the regulations doubled as it will lead to savings to the consumer for reduced gasoline consumption, decreased reliance on petroleum imports, environmental protection, and more jobs. The DOT is holding hearing on its latest proposal to ease efficiency standards for 1989-1990, and bills to repeal the law are pending in Congress.

  15. Green lasers are beyond power limits mandated by safety standards.

    PubMed

    Lee, M H; Fox, K; Goldwasser, S; Lau, D W M; Aliahmad, B; Sarossy, M

    2016-08-01

    There has been an increasing number of reports of people losing vision from laser exposure from pocket laser pointers despite the safety limit of 1 milliwatt (1mW) imposed by the Australian government. We hypothesize that this is because commercially available red and green laser pointers are exceeding their labeled power outputs. We tested the power outputs of 4 red and 4 green lasers which were purchased for less than AUD$30 each. The average of 10 measurements was recorded for each laser. We found that 3 out of 4 red lasers conformed to the 1mW safety standard; in contrast, all of the green lasers exceeded this limit, with one of the lasers recording an output of 127.9 mW. This contrast in compliance is explained by the construction of these lasers - green lasers are typically Diode Pumped Solid State (DPSS) lasers that can emit excessive infrared (IR) radiation with poor workmanship or inconsistent adherence to practices of safe design and quality control; red lasers are diode lasers which have limited power outputs due to `Catastrophic Optical Damage' (COD). Relevant professional bodies ought to advocate more strongly for stringent testing, quality control and licensing of DPSS lasers with a view towards government intervention to banning green laser pointer use.

  16. Payers' experiences with confidential pharmaceutical price discounts: A survey of public and statutory health systems in North America, Europe, and Australasia.

    PubMed

    Morgan, Steven G; Vogler, Sabine; Wagner, Anita K

    2017-04-01

    Institutional payers for pharmaceuticals worldwide appear to be increasingly negotiating confidential discounts off of the official list price of pharmaceuticals purchased in the community setting. We conducted an anonymous survey about experiences with and attitudes toward confidential discounts on patented pharmaceuticals in a sample of high-income countries. Confidential price discounts are now common among the ten health systems that participated in our study, though some had only recently begun to use these pricing arrangements on a routine basis. Several health systems had used a wide variety of discounting schemes in the past two years. The most frequent discount received by participating health systems was between 20% and 29% of official list prices; however, six participants reported their health system received one or more discount over the past two years that was valued at 60% or more of the list prices. On average, participants reported that confidential discounts were more common, complex, and significant for specialty pharmaceuticals than for primary care pharmaceuticals. Participants had a more favorable view of the impact of confidential discount schemes on their health systems than on the global marketplace. Overall, the frequency, complexity, and scale of confidential discounts being routinely negotiated suggest that the list prices for medicines bear limited resemblance to what many institutional payers actually pay.

  17. 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.

  18. State Programs for Funding Teacher Professional Development.

    ERIC Educational Resources Information Center

    Ward, James G.; St. John, Edward P.; Laine, Sabrina W. M.

    State mandates for teacher professional development and continuing education, and funding for those mandates are a high profile topic in the North Central region. Examination of specific state requirements for professional development, the relationship among professional development, teacher certification, and continued employment, and direct…

  19. Oil and water: mixing individual mandates, fragmented markets, and health reform.

    PubMed

    Hoffman, Allison K

    2010-01-01

    The 2010 federal health insurance reform act includes an individual mandate that will require Americans to carry health insurance. This article argues that even if the mandate were to catalyze universal health insurance coverage, it will fall short on some of the policy objectives many hope to achieve through a mandate if implemented in a fragmented insurance market. To uncover this problem, this article sets forth a novel framework that disentangles three different policy objectives the individual mandate can serve. Namely, supporters of the mandate might hope for it to: (1) facilitate greater health and financial security for the uninsured ("paternalism"); (2) eliminate inefficiencies in health care delivery and financing ("efficiency"); and/or (3) require the healthy to buy insurance to help fund medical care for the sick ("health redistribution"). Health redistribution--the primary focus of this article--is a shifting of wealth from the healthy to the sick through the mechanism of risk pooling. Many see health redistribution as a means to enable all Americans to more equitably access medical care on the basis of need, rather than on the basis of ability or willingness to pay. Drawing on evidence from the implementation of an individual mandate in Massachusetts's health reform in 2006, this article reveals that the fragmented American health insurance market will thwart the mandate's ability to achieve these objectives- in particular the goal of health redistribution. Fragmentation is an atomization of the insurance market into numerous risk pools that has been driven by market competition and regulation. It prevents Americans from sharing broadly in the risk of poor health and, in doing so, entrenches a system where access to medical care remains tied to ability to pay and individualized characteristics. The final section of this article examines how various policies, including some in the new law (e.g., insurance regulation and exchanges) and others not (e

  20. 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…

  1. 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.

  2. 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…

  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. 24 CFR 5.233 - Mandated use of HUD's Enterprise Income Verification (EIV) System.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Mandated use of HUD's Enterprise Income Verification (EIV) System. 5.233 Section 5.233 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS...

  6. 24 CFR 5.233 - Mandated use of HUD's Enterprise Income Verification (EIV) System.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Mandated use of HUD's Enterprise Income Verification (EIV) System. 5.233 Section 5.233 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS...

  7. Evaluation of a College Policy Mandating Treatment for Students with Substantiated Drinking Problems.

    ERIC Educational Resources Information Center

    Colby, John J.; Raymond, George A.; Colby, Suzanne M.

    2000-01-01

    Study reports the results of two surveys in which 215 students react to a policy mandating treatment for students receiving emergency room care due to alcohol abuse. Respondents identify many drinking problems that prompt student-to-student help, and predict that the policy would discourage helping but not reduce drinking. Proposes that college…

  8. 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…

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

    PubMed

    Block, Jonathan; Daly, Rich

    2013-07-08

    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.

  10. 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…

  11. 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…

  12. 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…

  13. Assessing Relationship Quality in Mandated Community Treatment: Blending Care with Control

    ERIC Educational Resources Information Center

    Skeem, Jennifer L.; Louden, Jennifer Eno; Polaschek, Devon; Camp, Jacqueline

    2007-01-01

    Traditional measures of the therapeutic alliance do not capture the dual roles inherent in relationships with involuntary clients. Providers not only care for, but also have control over, involuntary clients. In 2 studies of probationers mandated to psychiatric treatment (n = 90; n = 322), the authors developed and validated the revised Dual-Role…

  14. 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…

  15. 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…

  16. 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…

  17. 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,…

  18. 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…

  19. 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…

  20. Personal Consequences of Compliance and Resistance to Mandated Reforms for Teachers in Low-Performing Schools

    ERIC Educational Resources Information Center

    Burke, Christopher J. F.; Adler, Martha

    2013-01-01

    This case study examines the experiences of two fifth grade teachers as they dealt with district mandates while trying to address their high-poverty urban children's learning needs. It reveals their personal struggles that led to both compliance and resistance. In this case, the act of finding the space to engage in the intellectual and…

  1. Personal Consequences of Compliance and Resistance to Mandated Reforms for Teachers in Low-Performing Schools

    ERIC Educational Resources Information Center

    Burke, Christopher J. F.; Adler, Martha

    2013-01-01

    This case study examines the experiences of two fifth grade teachers as they dealt with district mandates while trying to address their high-poverty urban children's learning needs. It reveals their personal struggles that led to both compliance and resistance. In this case, the act of finding the space to engage in the intellectual and creative…

  2. 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…

  3. Steerage from a Distance: Can Mandated Accountability Systems Really Improve Schools?

    ERIC Educational Resources Information Center

    Aper, Jeffrey P.

    2002-01-01

    Discusses ways in which the logic of mandated systems of mass testing, as a means of ensuring the accountability of public schools, results in the loss of local responsibility for student learning, as well as an inevitable orientation of local schools to comply with system directives over personal, professional, and community values. (Contains 55…

  4. 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…

  5. High School Relationship and Marriage Education: A Comparison of Mandated and Self-Selected Treatment

    ERIC Educational Resources Information Center

    Halpern-Meekin, Sarah

    2011-01-01

    This study examines whether high school relationship and marriage education can affect students' relationship skills and if effects vary between sites having mandated and self-selected course participation. Based on an original data set (n = 222), results show that course exposure can result in a significant, positive change in students'…

  6. 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…

  7. 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

  8. 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…

  9. Federal Education Policies and Programs: Intergovernmental Issues in Their Design, Operation, and Effects. Volume 3: Congressionally Mandated Study of School Finance. A Final Report to Congress from the Secretary of Education.

    ERIC Educational Resources Information Center

    Kutner, Mark A.; And Others

    In response to a 1978 mandate, this concluding volume of the School Finance Project's final report concentrates on the broader intergovernmental issues relating to the design and transmission of federal policies and programs, and on the effects of federal activities on state and local education agencies and on schools. The specific Department of…

  10. 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...

  11. 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...

  12. 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....

  13. 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....

  14. 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....

  15. 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....

  16. 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....

  17. 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…

  18. 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

  19. 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.

  20. Ethical dilemma of mandated contraception in pharmaceutical research at catholic medical institutions.

    PubMed

    Casey, Murray Joseph; O'Brien, Richard; Rendell, Marc; Salzman, Todd

    2012-01-01

    The Catholic Church proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by such mandates to adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance.

  1. Beef up your information security with the new HIPAA-mandated standards.

    PubMed

    1999-12-01

    Beef up information security using HIPAA standards. This month, the federal Department of Health and Human Services will release the final standards for information security mandated by the 1996 Health Insurance Portability and Accountability Act (HIPAA). To comply with HIPAA, you must perform an applications and data criticality analysis and develop a data backup plan, a disaster recovery plan, and an emergency mode operation plan.

  2. The Comparative Effectiveness of Individual and Group Brief Motivational Interventions for Mandated College Students

    PubMed Central

    Hustad, John T. P.; Mastroleo, Nadine R.; Kong, Lan; Urwin, Rachel; Zeman, Suzanne; LaSalle, Linda; Borsari, Brian

    2014-01-01

    Individual brief motivational intervention (iBMI) is an efficacious strategy to reduce heavy drinking by students who are mandated to receive an alcohol intervention following an alcohol-related event. However, despite the strong empirical support for iBMI, it is unknown if the results from rigorously controlled research on iBMI translate to real-world settings. Furthermore, many colleges lack the resources to provide iBMI to mandated students. Therefore, group-delivered BMI (gBMI) might be a cost-effective alternative that can be delivered to a large number of individuals. The purpose of this study was to conduct a comparative effectiveness evaluation of iBMI and gBMI as delivered by staff at a university health services center. Participants (N = 278) were college students who were mandated to receive an alcohol intervention following an alcohol-related incident. Participants were randomized to receive an individual (iBMI; n = 133) or a Group BMI (gBMI; n = 145). Results indicated that both iBMI and gBMI participants reduced their peak estimated blood alcohol concentration (BAC) and the number of negative alcohol-related consequences at 1-, 3-, and 6-months postintervention. The iBMI and gBMI conditions were not significantly different at follow-up. These findings provide preliminary support for the use of iBMI and gBMIs for college students in real-world settings. PMID:24731111

  3. 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

  4. Nonadherence with Employer-Mandated Sleep Apnea Treatment and Increased Risk of Serious Truck Crashes

    PubMed Central

    Burks, Stephen V.; Anderson, Jon E.; Bombyk, Matthew; Haider, Rebecca; Ganzhorn, Derek; Jiao, Xueyang; Lewis, Connor; Lexvold, Andrew; Liu, Hong; Ning, Jiachen; Toll, Alice; Hickman, Jeffrey S.; Mabry, Erin; Berger, Mark; Malhotra, Atul; Czeisler, Charles A.; Kales, Stefanos N.

    2016-01-01

    Study Objectives: To evaluate the effect of an employer-mandated obstructive sleep apnea (OSA) program on the risk of serious preventable truck crashes. Methods: Data are from the first large-scale, employer-mandated program to screen, diagnose, and monitor OSA treatment adherence in the US trucking industry. A retrospective analysis of cohorts was constructed: polysomnogram-diagnosed drivers (OSA positive n = 1,613, OSA negative n = 403) were matched to control drivers unlikely to have OSA (n = 2,016) on two factors affecting crash risk, experience-at-hire and length of job tenure; tenure was matched on the date of each diagnosed driver's polysomnogram. Auto-adjusting positive airway pressure (APAP) treatment was provided to all cases (i.e. OSA positive drivers); treatment adherence was objectively monitored. Cases were grouped by treatment adherence: “Full Adherence” (n = 682), “Partial Adherence” (n = 571), or “No Adherence” (n = 360). Preventable Department-of-Transportation-reportable crashes/100,000 miles were compared across study subgroups. Robustness was assessed. Results: After the matching date, “No Adherence” cases had a preventable Department of Transportation-reportable crash rate that was fivefold greater (incidence rate ratio = 4.97, 95% confidence interval: 2.09, 10.63) than that of matched controls (0.070 versus 0.014 per 100,000 miles). The crash rate of “Full Adherence” cases was statistically similar to controls (incidence rate ratio = 1.02, 95% confidence interval: 0.48, 2.04; 0.014 per 100,000 miles). Conclusions: Nontreatment-adherent OSA-positive drivers had a fivefold greater risk of serious preventable crashes, but were discharged or quit rapidly, being retained only one-third as long as other subjects. Thus, the mandated program removed risky nontreatment-adherent drivers and retained adherent drivers at the study firm. Current regulations allow nonadherent OSA cases to drive at another firm by keeping their diagnosis

  5. Who should be doing what in the international health: a confusion of mandates in the United Nations?

    PubMed Central

    Lee, K.; Collinson, S.; Walt, G.; Gilson, L.

    1996-01-01

    Since 1945 at least five United Nations organisations have become substantially involved in international health activities. This has led to considerable confusion among policy makers, scholars, and UN staff over distinct and appropriate mandates. Interviews with staff an a historical analysis have shown that while formal mandates have been complementary, effective mandates have led to an unclear delineation of activities. The process of translating formal into effective mandates have been influenced by the decentralised nature of the UN, lack of a master plan for its activities, the considerable growth in the policy agenda and the shift towards a multisectoral approach to health. The identification of each organisation's comparative advantage, at both the global and country levels, is one way of understanding what each organisation does best and perhaps should be doing. There is a need for improved mechanisms to define effective mandates, taking into account comparative advantages, if the mandates of UN organisations are appropriate to meet future challenges in international health. PMID:8611793

  6. Medicare program; right of appeal for Medicare secondary payer determinations relating to liability insurance (including self-insurance), no-fault insurance, and workers' compensation laws and plans. Final rule.

    PubMed

    2015-02-27

    This final rule implements provisions of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act) which require us to provide a right of appeal and an appeal process for liability insurance (including self-insurance), no-fault insurance, and workers' compensation laws or plans when Medicare pursues a Medicare Secondary Payer (MSP) recovery claim directly from the liability insurance (including self-insurance), no-fault insurance, or workers' compensation law or plan.

  7. 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.)

  8. Pursuing cost containment in a pluralistic payer environment: from the aftermath of Clinton's failure at health care reform to the Balanced Budget Act of 1997.

    PubMed

    Mayes, Rick; Hurley, Robert E

    2006-07-01

    Following a decade in which Medicare operated as the leading 'change agent' within the US health care system, the private sector rose to the fore in the mid 1990s. The failure of President Clinton's attempt at comprehensive, public sector-led reform left managed care as the solution for cost control. And for a period it worked, largely because managed care organizations were able to both squeeze payments to selective networks of medical providers and significantly reduce inpatient hospital stays. There was a lot of 'fat' in the nation's convoluted health care system that could be (and was) eliminated through competitive negotiations between medical providers and insurers, employers, or managed care organizations. One of our primary arguments in this article is that managed care operated partly as a systematic suppression of price discrimination or differential pricing (often referred to as 'cost shifting'), as managed care organizations qua purchasing agents prevented hospitals and physicians from summarily raising prices to private payers to meet their financial requirements. Over time, however, managed care fell victim to inflated expectations, its own initial success, and larger fiscal forces. During this same period, Republicans and Democrats struggled to reach a consensus over the future direction of Medicare. Their disagreements contributed to the impasse over budget policy in 1995 and the infamous partial federal government shutdown. After President Clinton's reelection in 1996, partisan disagreements over Medicare dissipated. And, in 1997, Congress and the president passed the Balanced Budget Act of 1997, which emerged as a massive piece of patchwork legislation that sought to balance the federal budget, rein in Medicare spending, and increase the number of the programme's beneficiaries in private health plans.

  9. Teaching Kansas History: The State of the State.

    ERIC Educational Resources Information Center

    Isern, Thomas D.

    1990-01-01

    Provides a history of debate concerning issue of teaching Kansas state history in public schools as mandated by law. Studies show the failure to comply was a result of nonavailability of textbooks and lack of teacher preparation. Contends that State Department of Education did not support the law because state history is not taught in many Kansas…

  10. San Francisco's 'pay or play' employer mandate expanded private coverage by local firms and a public care program.

    PubMed

    Colla, Carrie H; Dow, William H; Dube, Arindrajit

    2013-01-01

    In 2008 San Francisco implemented a pay-or-play employer mandate that required firms operating in the city to provide health insurance coverage for employees or contribute to the city's "public option" health access program, Healthy San Francisco. Using data from our Bay Area Employer Health Benefits Survey, we found that in the first two years after implementation, more employers offered insurance and provided employee health benefit coverage relative to employers outside San Francisco not subject to the mandate. Sixty-seven percent reported in 2009 that they had expanded benefits since 2007. Although 22 percent of firms responding to the survey reported contributing to Healthy San Francisco for some employees, we observed no crowd-out of private insurance. Premium changes between 2007 and 2009 were similar in San Francisco and surrounding areas, but more of the burden of premium contributions in San Francisco shifted from workers to employers. Overall, 64 percent of firms responding to the survey supported the employer mandate. San Francisco's experience indicates that such a mandate is feasible, increases access, and is acceptable to many employers, which bodes well for the national employer mandate that will take effect under the Affordable Care Act in 2014.

  11. The Effect of the Affordable Care Act on Enrollment and Premiums, With and Without the Individual Mandate.

    PubMed

    Eibner, Christine; Price, Carter C

    2012-01-01

    This article describes the results of an analysis using RAND's COMPARE (Comprehensive Assessment of Reform Efforts) microsimulation model to predict the effects of a possible Supreme Court decision invalidating the individual mandate provision in the Patient Protection and Affordable Care Act of 2010 while keeping the other parts of the law intact. The authors predict the effects of such a decision on health insurance coverage overall and for subgroups based on income. They also estimate where people will obtain insurance in scenarios with and without the mandate and how the elimination of the individual mandate will affect insurance premiums. The analysis predicted that, if the individual mandate were to be eliminated: (1) 12.5 million people who would have otherwise signed up for coverage will be uninsured. (2) Premium prices in the non-group market will increase by 2.4 percent. (3) Total government spending will increase modestly, from $394 billion to $404 billion in 2016. (4) The amount of government spending per newly insured individual will more than double, from $3,659 to $7,468. The study estimates a smaller effect on premiums than comparable studies because the RAND team uses a method that accounts for the difference in the age composition of enrollees with and without the mandate.

  12. Implications of the biofuels policy mandate in Thailand on water: the case of bioethanol.

    PubMed

    Gheewala, Shabbir H; Silalertruksa, Thapat; Nilsalab, Pariyapat; Mungkung, Rattanawan; Perret, Sylvain R; Chaiyawannakarn, Nuttapon

    2013-12-01

    The study assesses the implications of the bioethanol policy mandate in Thailand of producing 9 M litre ethanol per day by 2021 on water use and water deprivation. The results reveal that water footprint (WF) of bioethanol varies between 1396 and 3105 L water/L ethanol. Cassava ethanol has the highest WF followed by molasses and sugarcane ethanol, respectively. However, in terms of fresh water (especially irrigation water) consumption, molasses ethanol is highest with 699-1220 L/L ethanol. To satisfy the government plan of bioethanol production in 2021, around 1625 million m(3) of irrigation water/year will be additionally required, accounting for about 3% of the current active water storage of Thailand. Two important watersheds in the northeastern region of Thailand are found to be potentially facing serious water stress if water resources are not properly managed. Measures to reduce water footprint of bioethanol are recommended.

  13. Should the Curriculum Be Set by State Fiat? An Empirical Test Using Economics Courses in High School. Occasional Paper.

    ERIC Educational Resources Information Center

    Belfield, Clive R.

    This paper estimates the effects of state-imposed curriculum mandates on the test scores of public-school students who took the SAT in 2001. By 1998, 14 states had mandates that high-school students should take an economics course. For these states, the proportion of public-school students taking high-school economics was around twice that of…

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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.

  1. Individual and Situational Factors that Influence the Efficacy of Personalized Feedback Substance Use Interventions for Mandated College Students

    PubMed Central

    Mun, Eun Young; White, Helene R.; Morgan, Thomas J.

    2010-01-01

    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 to either a PFI delivered in the context of a brief motivational interview (BMI; n = 180) or a written PFI only (WF) condition and followed up at 4 months and 15 months post-intervention. We empirically identified heterogeneous subgroups utilizing mixture modeling analysis based on heavy episodic drinking and alcohol-related problems. The four identified groups were dichotomized into an improved (53.4%) and a non-improved (46.6%) group. Logistic regression results indicated that the BMI was no more efficacious than the WF across all mandated students. However, mandated students who experienced a serious incident requiring medical or police attention and those with higher levels of alcohol-related problems at baseline benefited more from the BMI than from the WF. It may be an efficacious and cost-effective approach to provide a written PFI for low-risk mandated students and an enhanced PFI with a BMI for those who experience a serious incident or with higher baseline alcohol-related problems. PMID:19170456

  2. Individual and situational factors that influence the efficacy of personalized feedback substance use interventions for mandated college students.

    PubMed

    Mun, Eun Young; White, Helene R; Morgan, Thomas J

    2009-02-01

    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 months and 15 months postintervention. The authors empirically identified heterogeneous subgroups utilizing mixture modeling analysis based on heavy episodic drinking and alcohol-related problems. The 4 identified groups were dichotomized into an improved group (53.4%) and a nonimproved group (46.6%). Logistic regression results indicated that the BMI was no more efficacious than the WF across all mandated students. However, mandated students who experienced a serious incident requiring medical or police attention and those with higher levels of alcohol-related problems at baseline benefited more from the BMI than from the WF. It may be an efficacious and cost-effective approach to provide a written PFI for low-risk mandated students and an enhanced PFI with a BMI for those students who experience a serious incident or have higher baseline alcohol-related problems.

  3. Teachers' Perceptions of the Utilisation of Emotional Intelligence by Their School Principals to Manage Mandated Curriculum Change Processes

    ERIC Educational Resources Information Center

    Grobler, Bennie; Moloi, Connie; Thakhordas, Sunita

    2017-01-01

    This quantitative study investigates teachers' perceptions of how Emotional Intelligence (EI) was utilised by their school principals to manage mandated curriculum change processes in schools in the Johannesburg North district of Gauteng in South Africa. Research shows that EI consists of a range of fundamental skills that could enable school…

  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. Separating Wheat from Chaff: How Secondary School Principals' Core Values and Beliefs Influence Decision-Making Related to Mandates

    ERIC Educational Resources Information Center

    Larsen, Donald E.; Hunter, Joseph E.

    2014-01-01

    Research conducted by Larsen and Hunter (2013, February) identified a clear pattern in secondary school principals' decision-making related to mandated change: more than half of participants' decisions were based on core values and beliefs, requiring value judgments. Analysis of themes revealed that more than half of administrative decisions…

  7. 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)…

  8. Alcohol-related problems and life satisfaction predict motivation to change among mandated college students.

    PubMed

    Diulio, Andrea R; Cero, Ian; Witte, Tracy K; Correia, Christopher J

    2014-04-01

    The present study investigated the role specific types of alcohol-related problems and life satisfaction play in predicting motivation to change alcohol use. Participants were 548 college students mandated to complete a brief intervention following an alcohol-related policy violation. Using hierarchical multiple regression, we tested for the presence of interaction and quadratic effects on baseline data collected prior to the intervention. A significant interaction indicated that the relationship between a respondent's personal consequences and his/her motivation to change differs depending upon the level of concurrent social consequences. Additionally quadratic effects for abuse/dependence symptoms and life satisfaction were found. The quadratic probes suggest that abuse/dependence symptoms and poor life satisfaction are both positively associated with motivation to change for a majority of the sample; however, the nature of these relationships changes for participants with more extreme scores. Results support the utility of using a multidimensional measure of alcohol related problems and assessing non-linear relationships when assessing predictors of motivation to change. The results also suggest that the best strategies for increasing motivation may vary depending on the types of alcohol-related problems and level of life satisfaction the student is experiencing and highlight potential directions for future research.

  9. Evolutionary Evaluation: implications for evaluators, researchers, practitioners, funders and the evidence-based program mandate.

    PubMed

    Urban, Jennifer Brown; Hargraves, Monica; Trochim, William M

    2014-08-01

    Evolutionary theory, developmental systems theory, and evolutionary epistemology provide deep theoretical foundations for understanding programs, their development over time, and the role of evaluation. This paper relates core concepts from these powerful bodies of theory to program evaluation. Evolutionary Evaluation is operationalized in terms of program and evaluation evolutionary phases, which are in turn aligned with multiple types of validity. The model of Evolutionary Evaluation incorporates Chen's conceptualization of bottom-up versus top-down program development. The resulting framework has important implications for many program management and evaluation issues. The paper illustrates how an Evolutionary Evaluation perspective can illuminate important controversies in evaluation using the example of the appropriate role of randomized controlled trials that encourages a rethinking of "evidence-based programs". From an Evolutionary Evaluation perspective, prevailing interpretations of rigor and mandates for evidence-based programs pose significant challenges to program evolution. This perspective also illuminates the consequences of misalignment between program and evaluation phases; the importance of supporting both researcher-derived and practitioner-derived programs; and the need for variation and evolutionary phase diversity within portfolios of programs.

  10. Underdiagnosis of comorbid mental illness in repeat DUI offenders mandated to treatment.

    PubMed

    McMillan, Garnett P; Timken, David S; Lapidus, Jodi; C'de Baca, Janet; Lapham, Sandra C; McNeal, Megan

    2008-04-01

    Repeat offenders for DUI are routinely mandated to undergo alcohol treatment. These individuals have been shown to have high rates of co-occurring psychiatric disorders, which can be important for the conduct and outcomes of alcohol treatment. The extent to which treatment providers are aware of these disorders and modify treatment accordingly is unknown. As part of a larger study to investigate the impact of sanction conditions on probation outcomes, we screened 233 patients for psychiatric conditions and compared the findings with the psychiatric conditions identified during mandatory treatment by independent treatment providers. Adjusted rates of underdiagnosis were commonly high: 97.2% of bipolar disorder cases, 67.5% of major depression cases, 100% of obsessive-compulsive disorder cases, and 37.3% of drug use disorder cases remained undiagnosed during treatment. Rates of overdiagnosis were low for all disorders, with the exception of drug use disorders. These rates of underdiagnosis represent missed opportunities to improve treatment outcomes among repeat DUI offenders.

  11. Drinking before Drinking: Pre-gaming and Drinking Games in Mandated Students

    PubMed Central

    Boyle, Kelly E.; Hustad, John T. P.; Barnett, Nancy P.; Tevyaw, Tracy O'Leary; Kahler, Christopher W.

    2007-01-01

    Pre-gaming, the practice of consuming alcohol before attending a social function, has not received as much research attention as drinking games among college students. This study investigated the prevalence of both pre-gaming and drinking game participation in a sample of mandated students (N = 334) who had been referred for an alcohol violation. Approximately one-third (31%) of the sample reported pre-gaming on the night of their referral event. Pre-gaming was associated with higher estimated blood alcohol content on that night, along with a greater history of pre-gaming and taking greater responsibility for the incident. A higher proportion of the students (48.7%) reported playing drinking games on the event night and reported the event to be less aversive than non-players. Neither drinking games nor pre-gaming was consistently related to recent alcohol consumption or problems, nor did they frequently occur together on the event night. Pre-gaming was a unique predictor of intoxication on the night of the referral, and drinking games were not. Therefore, pre-gaming and drinking games appear to be distinct activities. This research suggests methods of prevention for both activities as well as promising research directions for future research. PMID:17574344

  12. 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.

  13. The likely effects of employer-mandated complementary health insurance on health coverage in France.

    PubMed

    Pierre, Aurélie; Jusot, Florence

    2017-03-01

    In France, access to health care greatly depends on having a complementary health insurance coverage (CHI). Thus, the generalisation of CHI became a core factor in the national health strategy created by the government in 2013. The first measure has been to compulsorily extend employer-sponsored CHI to all private sector employees on January 1st, 2016 and improve its portability coverage for unemployed former employees for up to 12 months. Based on data from the 2012 Health, Health Care and Insurance survey, this article provides a simulation of the likely effects of this mandate on CHI coverage and related inequalities in the general population by age, health status, socio-economic characteristics and time and risk preferences. We show that the non-coverage rate that was estimated to be 5% in 2012 will drop to 4% following the generalisation of employer-sponsored CHI and to 3.7% after accounting for portability coverage. The most vulnerable populations are expected to remain more often without CHI whereas non coverage will significantly decrease among the less risk averse and the more present oriented. With its focus on private sector employees, the policy is thus likely to do little for populations that would benefit most from additional insurance coverage while expanding coverage for other populations that appear to place little value on CHI.

  14. Under-diagnosis of comorbid mental illness in repeated DUI offenders mandated to treatment

    PubMed Central

    McMillan, Garnett P.; Timken, David S.; Lapidus, Jodi; C'de Baca, Janet; Lapham, Sandra C.; McNeal, Megan

    2008-01-01

    Repeated offenders for driving under the influence (DUI) offenders are routinely mandated to alcohol treatment. These individuals have been shown to have high rates of co-occurring psychiatric disorders, which can be important for the conduct and outcomes of alcohol treatment. The extent to which treatment providers are aware of these disorders and modify treatment accordingly is unknown. As part of a larger study to investigate the impact of sanction conditions on probation outcomes, we screened 233 subjects for psychiatric conditions and compared those findings to the psychiatric conditions identified during mandatory treatment by independent treatment providers. Adjusted rates of under-diagnosis were commonly high: 97.2% of bipolar, 67.5% of major depression, 100% of obsessive-compulsive, and 37.3% of drug use disorders remained undiagnosed during treatment. Rates of over-diagnosis were low for all disorders, with the exception of drug use disorders. These rates of under-diagnosis represent missed opportunities to improve treatment outcomes among repeat DUI offenders. PMID:17614243

  15. Outcomes and Recidivism in Mandated Batterer Intervention Before and After Introducing a Specialized Domestic Violence Court.

    PubMed

    Tutty, Leslie M; Babins-Wagner, Robbie

    2016-05-03

    Both specialized domestic violence (DV) courts and batterer intervention programs were developed to more adequately address intimate partner abuse and recidivism; however, little research has studied them concurrently. The current research examined clinical outcomes and police-reported recidivism in 382 men mandated to attend the Calgary Counselling Centre's Responsible Choices for Men's (RCM) groups between 1998 and 2009, before and after a specialized DV court was established in 2001. The study examines associations between categorical demographic and criminal justice variables, most of which were not correlated with post-group recidivism. Before the specialized court was implemented, 45 RCM members reported significantly more clinical issues at pretest than the 282 RCM members after court implementation (all scores adjusted by social desirability), although the effect sizes were negligible. Regarding group outcomes, depression, anxiety, and self-esteem (adjusted for social desirability) significantly improved on average for all RCM members irrespective of court implementation. Before the specialized DV court was developed, recidivism occurred after RCM program completion for a large proportion of men (41.2%), compared with only 8.2% after court implementation, a significant difference with a moderate effect size. The recidivism results are interpreted in the context of the significant justice and community collaborations entailed in creating the specialized DV court.

  16. MMR vaccination status of children exempted from school-entry immunization mandates

    PubMed Central

    Sethuraman, Karthik; Omer, Saad B.; Hanlon, Alexandra L.; Levy, Michael Z.; Salmon, Daniel

    2015-01-01

    BACKGROUND Child immunizations are one of the most successful public health interventions of the past century. Still, parental vaccine hesitancy is widespread and increasing. One manifestation of this are rising rates of nonmedical or “personal beliefs” exemptions (PBEs) from school-entry immunization mandates. Exemptions have been shown to be associated with increased risk of disease outbreak, but the strength of this association depends critically on the true vaccination status of exempted children, which has not been assessed. OBJECTIVE To estimate the true measles-mumps-rubella (MMR) vaccination status of children with PBEs. METHODS We use administrative data collected by the California Department of Public Health in 2009 and imputation to estimate the MMR vaccination status of children with PBEs under varying scenarios. RESULTS Results from 2009 surveillance data indicate MMR1/MMR2 coverage of 18–47% among children with PBEs at typical schools and 11–34% among children with PBEs at schools with high PBE rates. Imputation scenarios point to much higher coverage (64–92% for MMR1 and 25–58% for MMR2 at typical schools; 49–90% for MMR1 and 16–63% for MMR2 at high PBE schools) but still below levels needed to maintain herd immunity against measles. CONCLUSIONS These coverage estimates suggest that prior analyses of the relative risk of measles associated with vaccine refusal underestimate that risk by an order of magnitude of 2–10 times. PMID:26431991

  17. 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.

  18. 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…

  19. 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...

  20. 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

  1. Mandate for leadership: policy management in a conservative administration. [report by Heritage Foundation

    SciTech Connect

    Heatherly, C.L.

    1981-01-01

    Mandate for leadership was conceived in the fall of 1979 as a means of assisting the transition to a new administration in the event that a conservative President were elected in 1980. The premise was that conservatives must be prepared to answer the question, What is the conservative agenda, particularly for the first 100 days. The production of this volume has been an enterprise involving twenty project teams and over three hundred contributors. Three parts are devoted, respectively, to: (I) The Cabinet Departments (13 chapters); (II) Independent Regulatory Agencies (13 chapters); and (III) Other Agencies (6 chapters). Also, there is an epilogue, What the President Can Do by Executive Order. The authors of the chapters in this report were recruited as team chairmen for their respective agencies or groups of agencies; each then recruited a team for the production of the report according to certain guidelines. The principal credit for the success of the project belongs to these authors, who translated the concept of a transition report into a detailed and illuminating study of the executive branch of the federal government. The Environmental Protection Agency was pulled out of the regulatory reform group in mid-stream and established as an independent team with over fifty participants due to the mammoth size and unique character of the agency. Recommendations of this volume are not presented as cure-alls, but the editors feel that what is offered by the authors is a series of proposals which, if implemented, will help revitalize our economy, strengthen our national security, and halt the centralization of power in The Federal government. A separate abstract was prepared for each of three chapters, namely: (1) The Department of Energy; (2) The Department of Transportation; and (3) The Environmental Protection Agency.

  2. Paying for the Orphan Drug System: break or bend? Is it time for a new evaluation system for payers in Europe to take account of new rare disease treatments?

    PubMed

    Hughes-Wilson, Wills; Palma, Ana; Schuurman, Ad; Simoens, Steven

    2012-09-26

    higher price-points claimed by orphan drugs are unlikely to meet current cost-effectiveness thresholds. The authors propose the development of a new assessment system based on several evaluation criteria, which would serve as a tool for Member State governments to evaluate each new orphan drug at the time of pricing and reimbursement. These should include rarity, disease severity, the availability of other alternatives (level of unmet medical need), the level of impact on the condition that the new treatment offers, whether the product can be used in one or more indications, the level of research undertaken by the developer, together with other factors, such as manufacturing complexity and follow-up measures required by regulatory or other authorities. This will allow governments to value an orphan drug that fulfilled all the criteria very differently from one that only met some of them. An individual country could determine the (monetary) value that it places on each of the different criteria, according to societal preferences, the national healthcare system and the resources at its disposal - each individual government deciding on the weighting attributed to each of the criteria in question, based on what each individual society values most. Such a systematic and transparent system will help frame a more structured dialogue between manufacturers and payers, with the involvement of the treating physicians and the patients; and foster a more certain environment to stimulate continued investment in the field. A new approach could also offer pricing and reimbursement decision-makers a tool to handle the different characteristics amongst new orphan drugs and to redistribute the national budgets in accordance with the outcome of a differentiated assessment. The authors believe that this could, therefore, facilitate the approach for all stakeholders.

  3. 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.

  4. Getting off the Back Burner: Impact of Testing Elementary Social Studies as Part of a State-Mandated Accountability Program

    ERIC Educational Resources Information Center

    Vogler, Kenneth E.; Lintner, Timothy; Lipscomb, George B.; Knopf, Herman; Heafner, Tina L.; Rock, Tracy C.

    2007-01-01

    Social studies and social studies education is in the midst of what aptly can be described as a crisis of relevancy. In today's post-"No Child Left Behind" curriculum defined by test scores and proficiency targets, social studies has, as some have said, "been placed on the backburner" to make room for seemingly more important…

  5. 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…

  6. Intended and Unintended Effects of State-Mandated High School Science and Mathematics Course Graduation Requirements on Educational Attainment.

    PubMed

    Plunk, Andrew D; Tate, William F; Bierut, Laura J; Grucza, Richard A

    2014-06-01

    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.

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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

  12. Grounded Theory of Barriers and Facilitators to Mandated Implementation of Mental Health Care in the Primary Care Setting

    PubMed Central

    Benzer, Justin K.; Beehler, Sarah; Miller, Christopher; Burgess, James F.; Sullivan, Jennifer L.; Mohr, David C.; Meterko, Mark; Cramer, Irene E.

    2012-01-01

    Objective. There is limited theory regarding the real-world implementation of mental health care in the primary care setting: a type of organizational coordination intervention. The purpose of this study was to develop a theory to conceptualize the potential causes of barriers and facilitators to how local sites responded to this mandated intervention to achieve coordinated mental health care. Methods. Data from 65 primary care and mental health staff interviews across 16 sites were analyzed to identify how coordination was perceived one year after an organizational mandate to provide integrated mental health care in the primary care setting. Results. Standardized referral procedures and communication practices between primary care and mental health were influenced by the organizational factors of resources, training, and work design, as well as provider-experienced organizational boundaries between primary care and mental health, time pressures, and staff participation. Organizational factors and provider experiences were in turn influenced by leadership. Conclusions. Our emergent theory describes how leadership, organizational factors, and provider experiences affect the implementation of a mandated mental health coordination intervention. This framework provides a nuanced understanding of the potential barriers and facilitators to implementing interventions designed to improve coordination between professional groups. PMID:22900158

  13. 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

  14. 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…

  15. 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 Leadership…

  16. 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…

  17. The State of State Education Finance--Emerging Themes and Collapsing Constraints.

    ERIC Educational Resources Information Center

    Verstegen, Deborah A.; McGuire, C. Kent

    New directions in federal educational policy in the 1980s have had clear and consistent implications for state education finance systems. This study reviews the financing arrangements that have emerged during the 1980s at the state level, discusses the costs of new legislative mandates and state programs, and assesses the extent to which federal…

  18. 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

  19. Addressing unfunded training mandates in hospitals: engaging the private sector in low- and middle-income countries.

    PubMed

    Preker, Alexander S; Keuffel, Eric; Tuckman, Howard

    2010-01-01

    Health worker finance and provision are discussed in this article in the context of the global shortage of human resources. Key issues related to public and private finance or provision of tertiary health education institutions are highlighted, and costs, benefits, and feasibility of potential financing or provision solutions are identified. Engagement of the private sector can expand the resources available for education and align incentives to address an important inefficiency: the unfunded mandate of post-graduate in-service training at hospitals that jointly provide education and health services.

  20. The German Berufsgenossenschaften (institutions for statutory accident insurance and prevention): organisation, mandate and activities in the area of mental health.

    PubMed

    Paridon, Hiltraut M; Paridon, Christoph M; Bindzius, Fritz A

    2007-01-01

    The present article first describes the institution of the German Berufsgenossenschaften (BGs, the institutions for statutory accident insurance and prevention) and their mandate. Besides rehabilitation and compensation, these comprise the prevention of occupational accidents and diseases, and work-related hazards. The main focus within the area of mental health is the prevention work, but rehabilitation and compensation within the German social insurance system in general, and with respect to mental health, will also be explained. Furthermore, the prevention-rehabilitation interface will be illustrated and the cooperation with the health insurance institutions will be described. In the second part, selected results of a survey regarding mental health and stress will be presented.

  1. 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.

  2. Healthcare workers under a mandated H1N1 vaccination policy with employment termination penalty: a survey to assess employee perception.

    PubMed

    Winston, Lori; Wagner, Stephanie; Chan, Shu

    2014-08-20

    The ethical debate over mandatory healthcare worker (HCW) influenza vaccination is a heated one. Our study hospital instituted a mandatory employee influenza vaccination policy for the 2009-2010 influenza season during the highly publicized pandemic of the H1N1 "Swine Flu." Under this mandate there was no informed declination option, and termination of employment was the consequence for noncompliance. Our objective was to examine HCW perceptions of the H1N1 influenza virus, the vaccine, and the strict mandated vaccination policy. A survey was designed, distributed, and anonymously collected. In total, 202 completed questionnaires were obtained via accidental sampling by the investigators achieving a 100% response rate. Data analysis showed that 31.7% of surveyed HCWs felt the mandate was an infringement on their rights and 3.5% of HCWs would electively seek employment elsewhere. Significantly more nurses and clerks/technicians were opposed to the mandate compared to other types of employees. 96% felt that the mandating hospital should be liable should a significant adverse effect occur from receiving the vaccine. While the mandate helped to increase HCW influenza vaccination rates dramatically, the strict consequence of employment termination created negative feelings of coercion. Adopting a policy that includes a declination option with mandatory masking during influenza season might be a more widely acceptable and still adequate approach.

  3. Twentieth anniversary of the European Union health mandate: taking stock of perceived achievements, failures and missed opportunities – a qualitative study

    PubMed Central

    2013-01-01

    responsibilities defined in the EU health mandate, one can identify that these responsibilities were only partly fulfilled or acknowledged by the respondents. In general, the EU is a recognized public health player in Europe which over the past two decades, has begun to develop competencies in supporting, coordinating and supplementing member state health actions. However, the assurance of health protection in other European policies seems to require further development. PMID:24225055

  4. 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…

  5. 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.…

  6. State School Finance Litigation: A Background Paper.

    ERIC Educational Resources Information Center

    Larson, Lisa

    In October 1988, 48 suburban and greater Minnesota school districts, representing approximately 20 percent of the state's public elementary and secondary school students, filed a lawsuit claiming that Minnesota's school financing system violates the state's constitutional mandate for equality of educational opportunity. (A ruling in the case is…

  7. The interactive effects of antisocial personality disorder and court-mandated status on substance abuse treatment dropout.

    PubMed

    Daughters, Stacey B; Stipelman, Brooke A; Sargeant, Marsha N; Schuster, Randi; Bornovalova, Marina A; Lejuez, C W

    2008-03-01

    The present study sought to examine the interactive effects of court-mandated (CM) treatment and antisocial personality disorder (ASPD) on treatment dropout among 236 inner-city male substance users receiving residential substance abuse treatment. Of the 236 participants, 39.4% (n = 93) met criteria for ASPD and 72.5% (n = 171) were mandated to treatment through a pretrial release-to-treatment program. Results indicated a significant interaction between ASPD and CM status, such that patients with ASPD who were voluntarily receiving treatment were significantly more likely to drop out of treatment than each of the other groups. Subsequent discrete time survival analyses to predict days until dropout, using Cox proportional hazards regression, indicated similar findings, with patients with ASPD who were voluntarily receiving treatment completing fewer days of treatment than each of the other groups. These findings suggest the effectiveness of the court system in retaining patients with ASPD, as well as the role of ASPD in predicting treatment dropout for individuals who are in treatment voluntarily. Implications, including the potential value of the early implementation of specialized interventions aimed at improving adherence for patients with ASPD who are receiving treatment voluntarily, are discussed.

  8. Do Brief Personalized Feedback Interventions Work for Mandated Students or Is It Just Getting Caught That Works?

    PubMed Central

    White, Helene Raskin; Mun, Eun Young; Morgan, Thomas J.

    2009-01-01

    Studies evaluating the efficacy of brief interventions with mandated college students have reported declines in drinking from baseline to short-term follow-up regardless of intervention condition. A key question is whether these observed changes are due to the intervention or to the incident and/or reprimand. This study evaluates a brief personal feedback intervention (PFI) for students (N = 230), who were referred to a student assistance program because of infractions of university rules regarding substance use, to determine whether observed changes in substance are attributable to the intervention. Half the students received immediate feedback (at baseline and after the 2-month follow-up) and half received delayed feedback (only after the 2 mo. follow-up). Students in both conditions generally reduced their drinking and alcohol-related problems from baseline to the 2 mo. follow-up and from the 2 mo. to the 7 mo. follow-up; however, there were no significant between-group differences at either follow-up. Therefore, it appears that the incident and/or reprimand are important instigators of mandated student change, and that written PFIs do not enhance these effects on a short-term basis, but may on a longer-term basis. PMID:18298236

  9. 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…

  10. 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,…

  11. 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…

  12. 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…

  13. 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…

  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. 76 FR 66741 - Statutorily Mandated Designation of Difficult Development Areas and Qualified Census Tracts for 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-27

    ... Regulations Division at 202- 708-3055 (this is not a toll-free number). Individuals with speech or hearing... hubzone@sba.gov . A text telephone is available for persons with hearing or speech impairments at 202-708... under Section 42 of the IRC, as amended, for the use by political subdivisions of the states...

  16. A Survey of Community Sheltered Facilities: Implications for Mandated School Programs.

    ERIC Educational Resources Information Center

    Lynch, Kevin P.; Gerber, Paul J.

    1980-01-01

    A survey examined admission barriers, client and disability variables, program content, and levels of school/agency cooperation in adult activity, work activity, and sheltered workshops in a midwestern state which has a representative urban-suburban-rural profile. (Author/SB)

  17. 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…

  18. 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.

  19. 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.

  20. Defense Transportation: Air Force’s Airlift Study Met Mandate Requirements

    DTIC Science & Technology

    2015-05-26

    federal role as combat units and in their state role as first responders to natural disasters . The decision to retire these planes led to...support, (3) disaster response, and (4) humanitarian assistance—at the following five levels of operational risk: low, medium, moderate, high, and...stability and counterinsurgency operations; and (10) conduct humanitarian, disaster relief, and other operations. RAND completed this classified 2See

  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. 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.

  3. Response of heavy-drinking voluntary and mandated college students to a peer-led brief motivational intervention addressing alcohol use.

    PubMed

    Mastroleo, Nadine R; Oakley, William C; Eaton, Erica M; Borsari, Brian

    2014-01-01

    Little is known about the way in which mandated and heavy-drinking voluntary students comparatively respond to peer-led brief motivational interventions (BMIs) and the mediators and moderators of intervention effects. Research suggests that mandated students may be more defensive due to their involvement in treatment against their will and this defensiveness, in turn, may relate to treatment outcome. Furthermore, it is not clear how mandated and heavy-drinking voluntary students perceived satisfaction with peer-led BMIs relates to treatment outcomes. Using data from two separate randomized controlled trials, heavy drinking college students (heavy-drinking voluntary, n = 156; mandated, n = 82) completed a peer-led brief motivational intervention (BMI). Both mandated and heavy-drinking volunteer students significantly reduced drinking behaviors at 3-month follow-up, reported high levels of post-intervention session satisfaction, yet no effects for mediation or moderation were found. Findings offer continued support for using peer counselors to deliver BMIs; however, results regarding the mechanisms of change were in contrast to previous findings. Implications for treatment and future areas of research are discussed.

  4. 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.

  5. 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…

  6. 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…

  7. 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…

  8. Diazinon in surface waters before and after a federally-mandated ban.

    PubMed

    Banks, Kenneth E; Hunter, David H; Wachal, David J

    2005-11-01

    Samples collected from rural and urban streams in the City of Denton, Texas, USA were analyzed for the organophosphorus pesticide diazinon during the years preceding and following a United States Environmental Protection Agency ban on many diazinon uses. A network of 70 monitoring stations, based mainly on topography and hydrological considerations, were established within the three main watersheds of Denton. Monitoring stations were sampled monthly from March through August during periods of normal flow (baseflow), resulting in a total of 1243 samples collected during the years of 2001-2004. Pesticide concentrations were determined using commercially available enzyme-linked immunosorbent assays (ELISAs) specific for diazinon. Results from this temporally and spatially dense monitoring effort illustrated the impacts of a decrease in diazinon production during 2002, followed by a ban on most outdoor, non-agricultural diazinon retail sales imposed during 2003. The total number of samples exhibiting diazinon concentrations above the lower limits of detection (LLD) significantly decreased between 2001 through 2004 (Mantel-Haenszel Chi-Square test, p<0.0001, n=1243) and decreased significantly during the four monitoring years (Cochran-Armitage Trend test, z=-17.94, p<0.0001, n=1243). The total number of stations exhibiting at least one sample above the LLD during the four monitoring years showed similar patterns (Mantel-Haenszel Chi-Square test, p<0.0001; Cochran-Armitage Trend test, z=-3.21, p=0.0007; n=276). Results indicate that the phased reduction of outdoor, non-agricultural diazinon uses led to a highly significant decrease in surface water occurrences of this pesticide.

  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.

  10. 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…

  11. 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…

  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. 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: Participants were…

  14. Exploring the Relevance of Attachment Theory as a Dependent Variable in the Treatment of Women Mandated into Treatment for Domestic Violence Offenses

    ERIC Educational Resources Information Center

    Carney, Michelle Mohr; Buttell, Frederick P.

    2005-01-01

    Objective: The purpose of the study was to: (a) investigate the pre-treatment levels of interpersonal dependency and violence among women entering a 16-week, court-mandated, batterer intervention program (BIP) and determine if there were any associations between interpersonal dependency and violence; (b) investigate differences in demographic…

  15. 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

  16. "Because We Do Not Know Their Way": Standardizing Practices and Peoples through Habitus, the NCLB "Highly-Qualified" Mandate, and PRAXIS I Examinations

    ERIC Educational Resources Information Center

    Watanabe, Sundy

    2008-01-01

    Standardized testing, mandated by NCLB, can act as a barrier to prevent Indigenous students from entering teacher training programs and achieving "highly-qualified" certification upon exiting. Such regulations work against the nation-to-nation trust agreements that would place Indigenous teachers within Native school systems. Although…

  17. A Text Message Program as a Booster to In-Person Brief Interventions for Mandated College Students to Prevent Weekend Binge Drinking

    ERIC Educational Resources Information Center

    Suffoletto, Brian; Merrill, Jennifer E.; Chung, Tammy; Kristan, Jeffrey; Vanek, Marian; Clark, Duncan B.

    2016-01-01

    Objective: To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. Participants: Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. Methods: The SMS program sent drinking-related queries each Thursday and Sunday and…

  18. 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…

  19. Prescribing Proficiency: The Intersection of Teacher, Students and a Mandated Reading Program in One Elementary School Classroom in the Climate of High-Stakes Testing

    ERIC Educational Resources Information Center

    Bien, Andrea Caroline

    2013-01-01

    This dissertation addresses questions about the impact and consequences of current school reforms by examining how mandated packaged reading programs contribute to a commodification of knowledge that is changing conceptualizations of literacy, teaching, and learning. Grounded in cultural-historical theories of literacy and learning, this work…

  20. Portraiture of Cultural Responsive Leadership in Title 1 School Principals Implementing Mandates of No Child Left Behind Act within the Context of Parent Involvement

    ERIC Educational Resources Information Center

    Conley, Loraine

    2012-01-01

    The signing of the No Child Left Behind Act in 2001 created a need for Title 1 principals to conceptualize and operationalize parent engagement. This study examines how three urban principals in Arizona implemented the mandates of the Act as it pertains to parent involvement. The purpose of this qualitative case study is to examine how principals…

  1. 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…

  2. Improving the effect of FDA-mandated drug safety alerts with Internet-based continuing medical education.

    PubMed

    Kraus, Carl N; Baldwin, Alan T; McAllister, R G

    2013-02-01

    The US Food and Drug Administration (FDA) requires risk communication as an element of Risk Evaluation and Mitigation Strategies (REMS) to alert and educate healthcare providers about severe toxicities associated with approved drugs. The educational effectiveness of this approach has not been evaluated. To support the communication plan element of the ipilimumab REMS, a Medscape Safe Use Alert (SUA) letter was distributed by Medscape via email and mobile device distribution to clinicians specified in the REMS. This alert contained the FDA-approved Dear Healthcare Provider (DHCP) letter mandated for distribution. A continuing medical education (CME) activity describing ipilimumab toxicities and the appropriate management was simultaneously posted on the website and distributed to Medscape members. Data were collected over a 6-month period regarding the handling of the letter and the responses to pre- and post-test questions for those who participated in the CME activity. Analysis of the answers to the pre- and posttest questions showed that participation in the CME activity resulted in an improvement in correct answer responses of 47%. Our experience shows that there are likely distinct information sources that are utilized by different HCP groups. The ready availability of a brief CME activity was utilized by 24,063 individuals, the majority of whom showed enhanced understanding of ipilimumab toxicity by improvement in post-test scores, educational data that are not available via implementation of standard safety alert communications. These results demonstrate that improvement in understanding of specific drug toxicities is enhanced by a CME intervention.

  3. Outcome Evaluation of a Policy-Mandated Lifestyle and Environmental Modification Program in a National Job Training Center.

    PubMed

    Jimenez, Elizabeth Yakes; Harris, Amanda; Luna, Donald; Velasquez, Daniel; Slovik, Jonathan; Kong, Alberta

    2016-10-18

    Excess weight gain is common when adolescents become young adults, but there are no obesity prevention or weight management interventions that have been tested for emerging adults who follow non-traditional post-secondary paths, such as enrolling in job training programs. We evaluated Healthy Eating & Active Lifestyles (HEALs), a policy-mandated lifestyle education/environmental modification program, at a job training center for low-income 16-24 year olds. We examined average change in body mass index (BMI) z-score from baseline to 6 months for emerging adults (aged 16-24 years) in pre-HEALs implementation (n = 125) and post-HEALs implementation (n = 126) cohorts living at the job training center, by baseline weight status. In both cohorts, average BMI z-score significantly increased from baseline to 6 months for students with BMI < 25. Average BMI z-score significantly decreased for the overweight (BMI 25 to <30; -0.11, p = .03) and obese (BMI ≥ 30; -0.11, p = .001) students only within the post-HEALs cohort; changes within the pre-HEALs cohort and between cohorts were not significant. HEALs may promote positive weight-related trends for overweight/obese students, but prevention efforts for non-overweight/obese students need to be improved.

  4. State Norms for the North Carolina Testing Program. 1998 Edition.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of Accountability/Testing.

    This publication provides a reference for educators and others interested in conducting comparative studies relative to North Carolina tests. It includes norms, tables, and other statistical information for all state-developed tests (state-mandated and local-option tests for which baseline data are available) that were administered during the…

  5. Analyzing Sustainability Themes in State Science Standards: Two Case Studies

    ERIC Educational Resources Information Center

    Miller, Hannah K.; Jones, Linda Cronin

    2014-01-01

    Due to the interdisciplinary nature of environmental education, addressing the range of socioscientific issues included under the umbrella of sustainability can be challenging for educators working within the context of mandated state subject area standards. Two states (Washington and Vermont) have been recognized as leaders in incorporating…

  6. Constitutional Obligations for Public Education: 50-State Review

    ERIC Educational Resources Information Center

    Parker, Emily

    2016-01-01

    Within the constitution of each of the 50 states, there is language that mandates the creation of a public education system. The authority for public education falls to states because of a 1973 Supreme Court case which determined that the federal government has no responsibility to provide systems of public education. These constitutional…

  7. The State Data Analysis Gap: A Threat to Education Reform

    ERIC Educational Resources Information Center

    Sheeky, Art

    2011-01-01

    Ever since the 2001 passage of the No Child Left Behind Act (NCLB), states have faced a federal mandate to improve their ability to collect and analyze education data for the purpose of tracking and reporting the progress of their education reform efforts. With the assistance of federal funds, virtually all of the states are developing…

  8. Mitigating the health impacts of pollution from oceangoing shipping: an assessment of low-sulfur fuel mandates.

    PubMed

    Winebrake, J J; Corbett, J J; Green, E H; Lauer, A; Eyring, V

    2009-07-01

    Concerns about health effects due to emissions from ships have magnified international policy debate regarding low-sulfur fuel mandates for marine fuel. Policy discussions center on setting sulfur content levels and the geographic specification of low-sulfur fuel use. We quantify changes in premature mortality due to emissions from ships under several sulfur emissions control scenarios. We compare a 2012 No Control scenario (assuming 2.7% or 27 000 ppm S) with three emissions control scenarios. Two control scenarios represent cases where marine fuel is limited to 0.5% S (5000 ppm) and 0.1% S (1000 ppm) content, respectively, within 200 nautical miles of coastal areas. The third control scenario represents a global limit of 0.5% S. We apply the global climate model ECHAMSSy-MESSy1-MADE to geospatial emissions inventories to determine worldwide concentrations of particular matter (PM2.5) from ocean going vessels. Using those PM2.5 concentrations in cardiopulmonary and lung cancer concentration-risk functions and population models, we estimate annual premature mortality. Without control, our central estimate is approximately 87 000 premature deaths annually in 2012. Coastal area control scenarios reduce premature deaths by approximately 33 500 for the 0.5% case and approximately 43 500 for the 0.1% case. Where fuel sulfur content is reduced globally to 0.5% S, premature deaths are reduced by approximately 41 200. These results provide important support that global health benefits are associated with low-sulfur marine fuels, and allow for relative comparison of the benefits of alternative control strategies.

  9. Diabetes benefit management: evolving strategies for payers.

    PubMed

    Tzeel, Albert L

    2011-11-01

    Over the next quarter century, the burden of type 2 diabetes mellitus (T2DM) is expected to at least double. Currently, 1 in every 10 healthcare dollars is spent on diabetes management; by 2050, it has been projected that the annual costs of managing T2DM will rise to $336 billion. Without substantial, systemic changes, T2DM management costs will lead to a potentially untenable strain on the healthcare system. However, the appropriate management of diabetes can reduce associated mortality and delay comorbidities. In addition, adequate glycemic control can improve patient outcomes and significantly reduce diabetes-related complications. This article provides an overview of key concepts associated with a value-based insurance design (VBID) approach to T2DM coverage. By promoting the use of services or treatments that provide high benefits relative to cost, and by alternatively discouraging patients from utilizing services whose benefits do not justify their cost, VBID improves the quality of healthcare while simultaneously reining in spending. VBID initiatives tend to focus on chronic disease management and generally target prescription drug use. However, some programs have expanded their scope by incorporating services traditionally offered by wellness and disease management programs. The concept of VBID is growing, and it is increasingly being implemented by a diverse and growing number of public and private entities, including pharmacy benefit managers, health plans, and employers. This article provides key background on VBID strategies, with a focus on T2DM management. It also provides a road map for health plans seeking to implement VBID as part of their programs.

  10. Advances in electirc vehicle technology from 1990 to 1995: The role of California`s zero emission vehicle mandate. Final report

    SciTech Connect

    1996-02-01

    The California Air Resources Board will soon require that auto-makers offer for sale Ifizero emission vehicles`` (ZEVS) in California. Starting in 1998, the auto-makers subject to this mandate will be those who sell more than 35,000 vehicles in California whose laden weight is less than 3,750 lb. They must offer for sale ZEVs in sufficient numbers that at least 2 percent of all the vehicles (under the weight limit) that the offer for sale, are ZEVS. The effects we trace here are advances in EVs and EV technologies and increases in commercial and public investment in these vehicles and technologies. In particular, we examine how EVs have improved from 1990 to the present. We measure economic and technological activity in three ways. First, we examine changes in overall vehicle performance. Top speed, acceleration, driving range, recharging time, availability of amenities and options, and real world driving impressions tell us how well EVs perform. Second, we examine changes in the performance of individual components and systems. We measure aggregate changes in activity through the formation of business and government consortia and overall technological inventiveness and innovation as evidenced by patents. We show that much of the improvement to EVs made in the 1990s can be directly traced to the ZEV mandate. By setting the time at which EVs must be brought to market, the ZEV mandate summoned the resources, fired the imaginations, and rekindled the interest of many entrepreneurs, governments, utilities and consumers.

  11. Research With Children Exposed to Partner Violence: Perspectives of Service-Mandated, CPS- and Court-Involved Survivors on Research With Their Children.

    PubMed

    Rizo, Cynthia F; Macy, Rebecca J; Ermentrout, Dania M; O'Brien, Jennifer; Pollock, McLean D; Dababnah, Sarah

    2015-07-24

    Rapidly growing numbers of female survivors of intimate partner violence (IPV) who are the primary caregivers for their children are being mandated to services by child protective services (CPS) and/or the court system. Research is needed to better understand the experiences of these children; however, such research is hindered by the dearth of empirical evidence to guide researchers in how best to recruit and collect data about and from IPV-exposed children whose families are mandated to services. From a qualitative study with 21 CPS- and/or court-involved mothers, this article reports findings about participants' perspectives regarding research with their IPV-exposed children. Our analyses determined three key findings: (a) mothers' reasons or motivations for allowing their children to participate in research, (b) mothers' reasons for refusing consent for their children to participate, and (c) strategies for increasing research participation among this population. Based on these findings, we offer recommendations for enhancing research participation among IPV-exposed children from CPS- and/or court-involved families mandated to services, including specific recruitment and data collection strategies. These recommendations and strategies also hold value for research with other vulnerable families and children struggling with violence.

  12. Occupant injury and fatality in general aviation aircraft for which dynamic crash testing is certification-mandated.

    PubMed

    Boyd, Douglas D

    2015-06-01

    Towards further improving general aviation aircraft crashworthiness, multi-axis dynamic tests have been required for aircraft certification (14CFR23.562) since 1985. The objective of this study was to determine if occupants in aircraft certified to these higher crashworthiness standards show a mitigated fraction of fatal accidents and/or injury severity. The NTSB aviation database was queried for accidents occurring between 2002 and 2012 involving aircraft certified to, or immune from, dynamic crash testing and manufactured after 1999. Only operations conducted under 14CFR Part 91 were considered. Statistical analysis employed proportion tests and logistic regression. Off-airport landings are associated with high decelerative forces; however for off-airport landings, the fraction of fatal accidents for aircraft subject to, or exempt from, dynamic crash testing was similar (0.53 and 0.60, respectively). Unexpectedly, for on-airport landings a higher fraction of fatalities was evident for aircraft whose certification mandated dynamic crash testing. Improved crashworthiness standards would be expected to translate into a reduced severity of accident injuries. For all accidents, as well as for those deemed survivable, the fraction of minor and serious injuries was reduced for occupants in aircraft certified to the higher crashworthiness standards. Surprisingly, the fraction of occupants fatally injured was not decreased for aircraft subject to dynamic crash tests. To shed light on this unexpected finding flight history, airman demographics and post-impact fires for aircraft for which dynamic crash testing is mandatory or exempt was examined. For the former cohort the median distance of the accident flight was nearly 44% higher. Aircraft subject to dynamic crash testing were also involved in a greater fraction (0.25 versus 0.12, respectively) of post-impact fires. Our data suggest that while the more stringent crashworthiness standards have mitigated minor and serious

  13. The status of state-wide policies for neonatal hearing screening.

    PubMed

    Blake, P E; Hall, J W

    1990-04-01

    During the process of establishing follow-up procedures for our neonatal hearing program, we became interested in the current status of screening programs nationwide. Fifty states and the District of Columbia were surveyed to determine the extent and content of legislatively mandated neonatal hearing screening programs. Fourteen states have legislative mandates for screening and, at this point, approximately 50 percent of the states have no state-wide policy regarding neonatal hearing screening. Among the various state-wide protocols two basic approaches emerged: (1) the high-risk register and (2) in-hospital screening. In addition, information was obtained on screening methods, the level of program implementation, and some of the pros and cons for mandating neonatal hearing screening.

  14. Teacher Performance Plays Growing Role in Employment Decisions. Teacher Tenure: Trends in State Laws

    ERIC Educational Resources Information Center

    Thomsen, Jennifer

    2014-01-01

    An increasing number of states are mandating teacher performance be considered in educator employment decisions, including awarding tenure and layoffs, according to a 50-state policy review of teacher tenure laws. Tenure laws have historically granted job protections based on years of employment. The Education Commission of the States (ECS)…

  15. Settling a U.S. Senatorial Debate: Understanding Declines in State Higher Education Funding

    ERIC Educational Resources Information Center

    Klein, Michael W.

    2015-01-01

    This paper examines the debate in the U.S. Senate over the reasons why state governments have decreased funding for higher education. One side believes that federal mandates on states to pay for Medicaid have forced them to reduce spending on higher education. The other side believes that states unwisely reduced taxes, which decreased their…

  16. A Comprehensive Analysis of High School Genetics Standards: Are States Keeping Pace with Modern Genetics?

    ERIC Educational Resources Information Center

    Dougherty, M. J.; Pleasants, C.; Solow, L.; Wong, A.; Zhang, H.

    2011-01-01

    Science education in the United States will increasingly be driven by testing and accountability requirements, such as those mandated by the No Child Left Behind Act, which rely heavily on learning outcomes, or "standards," that are currently developed on a state-by-state basis. Those standards, in turn, drive curriculum and instruction.…

  17. A Comprehensive Fifty-One Jurisdiction Review of Statutes Mandating and Encouraging the Teaching of History in K-12 Schools

    ERIC Educational Resources Information Center

    Cutting, A. Edward

    2012-01-01

    This is a linear review of the education statutes of each state for the purpose of identifying those statutes which require the state's history to be taught in its K-12 schools, with further analysis for trends and outliers. The intent is to first serve as a benchmark as to where both each state and the nation as a whole is at this point in time.…

  18. Cost-effectiveness analysis of treatment with peginterferon-alfa-2a versus peginterferon-alfa-2b for patients with chronic hepatitis C under the public payer perspective in Brazil

    PubMed Central

    2013-01-01

    Background Chronic hepatitis C affects approximately 170 million people worldwide, and thus being one of the main causes of chronic liver disease. About 20% of patients with chronic hepatitis C will develop cirrhosis over 20 years, and present an increased risk of developing hepatic complications. Sustained virological response (SVR) is associated with a better prognosis compared to untreated patients and treatment failures. The objective of this analysis was to compare treatment costs and outcomes of pegylated interferon-alfa-2a versus pegylated interferon-alfa-2b, both associated with ribavirin, in the therapeutic scheme of 24 weeks and 48 week for hepatitis C genotypes 2/3 and genotype 1, respectively, under the Brazilian Public Health System (SUS) scenario. Methods To project disease progression, a Markov model was built based on clinical stages of chronic disease. A Delphi panel was conducted to evaluate medical resources related to each stage, followed by costing of related materials, services, procedures and pharmaceutical products. The evaluation was made from a public payer perspective. The source used for costing was government reimbursement procedures list (SAI/SIH–SUS). Drug acquisition costs were obtained from the Brazilian Official Gazette and “Banco de Preços em Saúde” (government official source). It was assumed a mean patient weight of 70 kg. Costs were reported in 2011 Brazilian Reais (US$1 ≈ $Brz1.80). A systematic review followed by a meta-analysis of the 7 identified randomized controlled trials (RCTs) which compared pegylated interferons, was conducted for obtaining relative efficacy of both drugs: for genotype 2/3, mean rate of SVR was 79.2% for peginterferon-alfa-2a and 73.8% for peginterferon-alfa-2b. For genotype 1, SVR mean rate was 42.09% versus 33.44% (peginterferon-alfa-2a and peginterferon-alfa-2b respectively). Time horizon considered was lifetime. Discount rate for costs and outcomes was 5%, according to Brazilian

  19. State Departments of Education and the New Teacher Centers Program.

    ERIC Educational Resources Information Center

    Lewis, Carol; And Others

    This publication is a compendium of resources gathered to aid state education agency (SEA) staff members as they set about implementing the federal Teacher Centers Program established by Public Law 94-482. The document details (1) the role of SEAs as mandated in that legislation, (2) the responsibility of SEAs in the initial review and screening…

  20. Resolving Conflicts of Interest in State-Owned Enterprises

    ERIC Educational Resources Information Center

    Radon, Jenik; Thaler, Julius

    2005-01-01

    State-owned enterprises (SOEs) face conflicts of interest that stem from a government's dual role as an owner, operator and businessman on the one hand and as the protector of the public interest and therefore a regulator of the SOE on the other hand. Besides pursuing profit maximisation like any private business, SOEs often have a mandate if not…

  1. The Implications of State Fiscal Policies for Community Colleges

    ERIC Educational Resources Information Center

    Dowd, Alicia C.; Shieh, Linda Taing

    2014-01-01

    A variety of policies and practices, including those developed by local boards and administrations, as well as those mandated by state and federal governments, affect budgets and finances at community colleges. Examples include tuition policies, fee structures, performance-based funding, and personnel policies. This chapter explores some of the…

  2. California Community Colleges State and Federal Legislative Programs, 1993.

    ERIC Educational Resources Information Center

    California Community Colleges, Sacramento. Board of Governors.

    A major component of the legislative function of the Board of Governors (BOG) of the California Community Colleges (CCC), as mandated in Assembly Bill 1725, is the adoption of an annual state and federal legislative program. This program formalizes the legislative thrust of the BOG and is intended to set forth systematic legislative and budgetary…

  3. State Administration of the Amended Chapter 1 Program.

    ERIC Educational Resources Information Center

    Turnbull, Brenda J.; And Others

    This report presents survey data, as of early 1990, on administration of the Hawkins-Stafford Amendments of the Elementary and Secondary School Act and on the continuing functions of state education agencies (SEAs), such as application review and monitoring. The Hawkins-Stafford amendments are designed to mandate accountability for student…

  4. The Relationship between Classworks and Georgia State Testing

    ERIC Educational Resources Information Center

    Baker, Amanda

    2014-01-01

    As teachers in Georgia utilize formative assessments to ensure successful performance on the state mandated Criterion Referenced Competency Test (CRCT), it is essential that the data they receive from these assessments are accurate. This study examined the correlation between the computer-assisted instructional program, Classworks, and student…

  5. Treating Female Perpetrators: State Standards for Batterer Intervention Services

    ERIC Educational Resources Information Center

    Kernsmith, Poco; Kernsmith, Roger

    2009-01-01

    Although domestic violence has historically been considered primarily a crime perpetrated by men, increasing numbers of women are being arrested and mandated into batterer intervention programs. This study examined existing state policies to explore the degree to which they address the unique needs of women in batterer intervention programs.…

  6. Protection for Pre-1972 Sound Recordings under State Law and Its Impact on Use by Nonprofit Institutions: A 10-State Analysis. CLIR Publication No. 146

    ERIC Educational Resources Information Center

    Council on Library and Information Resources, 2009

    2009-01-01

    This is the third of three studies of copyright and sound recordings commissioned by the National Recording Preservation Board (NRPB) in support of the congressionally mandated study of the state of audio preservation in the United States. All three studies have focused on how laws pertaining to sound recordings made before 1972 affect…

  7. REGIONAL AND STATE VIEWS OF ESTUARINE CONDITION IN NORTHEASTERN UNITED STATE BASED ON 2001 AND 2001 NATIONAL COASTAL ASSESSMENT DATA

    EPA Science Inventory

    The National Coastal Assessment (NCA) is a probability-based survey that permits assessment of estuarine conditions at national, regional, or large-system scales. Additionally, states may use these data to comply with requirements of the Clean Water Act (CWA), which mandates re...

  8. Early effects of the federally mandated Local Wellness Policy on school nutrition environments appear modest in Colorado's rural, low-income elementary schools.

    PubMed

    Belansky, Elaine S; Cutforth, Nick; Delong, Erin; Litt, Jill; Gilbert, Lynn; Scarbro, Sharon; Beatty, Bridget; Romaniello, Cathy; Brink, Lois; Marshall, Julie A

    2010-11-01

    To increase opportunities for healthy eating and physical activity, US school districts participating in the National School Lunch Program were required to create a Local Wellness Policy (LWP) by June 2006. The What's Working project described the initial influence of this mandate on nutrition environments and policies. In 2005 and 2007 (before and after the mandate went into effect), a survey about school features related to nutrition and physical activity was sent to a random sample of 45 low-income, rural elementary foodservice managers and principals. Schools averaged 204 students, 27% Hispanic. Districts' LWPs were coded for strength and comprehensiveness. In addition, key informant interviews were conducted with foodservice managers almost 2 years after the LWP went into effect. Three improvements were observed: increases in the percent of schools with policies stipulating predominantly healthy items be offered in classroom parties (21.4% in 2005 vs 48.7% in 2007), daily fresh fruit offerings in the lunchroom (0.80 choices in 2005 vs 1.15 choices in 2007), and the percent of schools using skinless poultry (27% in 2005 vs 59% in 2007). LWPs were weakly worded and rarely addressed energy content. Nutrition guideline elements most commonly addressed included vending machines, school stores, and à la carte food offerings. Seveny-three percent of foodservice managers were familiar with their district's LWP but did not perceive it changed lunchroom practices. Although LWPs offer a framework to support opportunities for healthy eating, few evidence-based practices were implemented as a direct result of the mandate. Schools need more information about evidence-based practices, as well as technical and financial assistance for implementation.

  9. Demystifiying state health insurance marketplaces.

    PubMed

    Hahn, Joyce A; Sheingold, Brenda Helen; Ott, Karen M

    2013-01-01

    The state health insurance exchanges, mandated under the Patient Protection and Affordable Care Act, will impact how health care is delivered and reimbursed, and will touch the lives of nurses in all professional roles. The dynamics of how each model will operate within each state is currently a work in progress. Nurses have a tradition of providing voice and leadership in the health care reform arena from the unique position as both consumers and health care professionals. The time is right to contact state legislators and advocate for nurses to sit on the governing boards of the state health care exchanges. Communication between nurses in all states should be an ongoing dialogue through specialty and state nursing organizations to ensure nursing is aware of both issues and best practices nationwide.

  10. The appropriateness of the NC state-mandated reading competency test for deaf students as a criterion for high school graduation.

    PubMed

    Lollis, Jana; LaSasso, Carol

    2009-01-01

    Deaf students consistently score lower on standardized measures of reading comprehension than their hearing peers. Most of the studies that have been conducted to explain this phenomenon have focused on variables within the reader, and important differences have been found between deaf and hearing readers. More recently, in the face of increasingly high-stakes consequences, researchers are looking "outside" the reader, at the tests themselves, to determine whether there are fairness issues for special populations, such as deaf students. The study reported here, the first of its kind with deaf students, examines the North Carolina (NC) reading comprehension test. The study employs the same method used originally by NC to determine its appropriateness of the test for the general population of NC students. The experts in this article, like those in the original construction of the NC test, are familiar with the content of the reading curriculum in NC; however, the raters in this article bring a special perspective related to teaching and testing reading of students who are deaf. Findings from this study raise questions about the appropriateness of the NC reading test for deaf students. Implications for future research and instructional practice are discussed.

  11. Heavy Meddle: A Critique of the North Carolina Department of Public Instruction's Plan to Mandate School District Mergers Throughout the State.

    ERIC Educational Resources Information Center

    Sher, Jonathan P.; Schaller, Karin

    At the request of the North Carolina School Boards Association, a nationally recognized expert on school and school district consolidation evaluated the 1986 North Carolina Department of Public Instruction (DPI) plan for school district consolidation from the perspective of economic, educational, and social/political considerations, including the…

  12. In What Ways is the New Jersey County Vocational School Admissions Criteria a Predictor of Student Success on State Mandated Tests?

    ERIC Educational Resources Information Center

    Rubin, Scott; Ramaswami, Soundaram

    2013-01-01

    Vocational and Technical Education (VTE) at the secondary-school level has undergone transformation, especially in the last 25 to 30 years brought about by the implementation of the Carl D. Perkins Vocational and Technical Education Act of 1984. Earlier, the VTE education focus was to prepare students for entry-level jobs that did not require a…

  13. Alcohol Use, Alcohol-Related Outcome Expectancies, and Partner Aggression among Males Court-Mandated to Batterer Intervention Programs: A Brief Report

    PubMed Central

    Brasfield, Hope; Morean, Meghan; Febres, Jeniimarie; Shorey, Ryan C.; Moore, Todd; Zucosky, Heather; Elmquist, JoAnna; Wolford-Clevenger, Caitlin; Labrecque, Lindsay; Plasencia, Maribel; Stuart, Gregory L.

    2015-01-01

    Additional work is needed to determine how and/or why the relationship between alcohol use and increased risk for partner aggression exists. Researchers have begun to examine whether alcohol-related outcome expectancies (i.e., beliefs about the cognitive and behavioral effects of alcohol) are associated with partner aggression irrespective of alcohol use. We examined the relationship between alcohol use, alcohol expectancies, and partner aggression among 360 males arrested for a domestic violence offense and court-mandated to treatment. Results indicate that certain alcohol expectancies do play a role in the relationship between alcohol use and some forms of partner aggression. PMID:25519237

  14. Alcohol Use, Alcohol-Related Outcome Expectancies, and Partner Aggression Among Males Court-Mandated to Batterer Intervention Programs: A Brief Report.

    PubMed

    Brasfield, Hope; Morean, Meghan E; Febres, Jeniimarie; Shorey, Ryan C; Moore, Todd M; Zuckosky Zapor, Heather; Elmquist, JoAnna; Wolford-Clevenger, Caitlin; Labrecque, Lindsay; Plasencia, Maribel; Stuart, Gregory L

    2016-01-01

    Additional work is needed to determine how and/or why the relationship between alcohol use and increased risk of partner aggression (PA) exists. Researchers have begun to examine whether alcohol-related outcome expectancies (i.e., beliefs about the cognitive and behavioral effects of alcohol) are associated with PA irrespective of alcohol use. We examined the relationship between alcohol use, alcohol expectancies, and PA among 360 males arrested for a domestic violence offense and court-mandated to treatment. Results indicate that certain alcohol expectancies do play a role in the relationship between alcohol use and some forms of PA.

  15. Learning guide for state/local drinking water agreements

    SciTech Connect

    Not Available

    1992-01-01

    The 1986 Amendments to the Safe Drinking Water Act mandated sweeping changes in the scope and costs of state drinking water programs. Some states are maximizing available resources by relying on local governments to carry out some of their drinking water responsibilities. The guidebook was developed to provide states and local governments using this approach with practical advice and suggestions about formal agreements related to Safe Drinking Water Act responsibilities.

  16. Mandatory mouthguard rules for high school athletes in the United States.

    PubMed

    Mills, Stephen C

    2015-01-01

    High school athletes seem particularly predisposed to dental injury, but athletic mouthguards have an excellent track record of success in reducing the severity and incidence of dental injuries in sports. Therefore, it has been suggested that mouthguards be made mandatory for high school athletes who participate in sports with risk of injury. The National Federation of State High School Associations currently recommends that mouthguards be mandated for high school football, lacrosse, ice hockey, and field hockey players as well as for wrestlers who are wearing orthodontic appliances. Different states have tried to mandate additional sports with varying degrees of success. This article summarizes the process that leads to rule changes for high school athletes at the national level and discusses the history of 4 states--Minnesota, Maine, New Hampshire, and Massachusetts--that have tried to mandate mouthguards for different sports. Common complaints that lead to the cessation of mouthguard rules, such as speech considerations, breathing ability, and cleanliness, are discussed.

  17. The Role of District Office Leaders in the Adoption and Implementation of the Common Core State Standards in Elementary Schools

    ERIC Educational Resources Information Center

    Durand, Francesca T.; Lawson, Hal A.; Wilcox, Kristen Campbell; Schiller, Kathryn S.

    2016-01-01

    Purpose: This multiple case study investigated district leaders' orientations and strategies as their elementary schools proceeded with state-mandated implementation of the Common Core State Standards (CCSS). We identified differences between schools achieving above-predicted outcomes on state CCSS assessments ("odds-beaters") and…

  18. A Qualitative Study of Teacher and Principal Perceptions of Washington State Teacher Evaluation Instruments: Danielson, Marzano, and CEL 5D+

    ERIC Educational Resources Information Center

    Coulter, Matthew Paul

    2013-01-01

    The purpose of this study was to describe the level of support teachers and principals have toward the new mandated teacher evaluation instruments in the state of Washington. In 2010, the Washington state legislature passed SB 6696 which essentially overhauled the system of how principals evaluate teachers in the state. The bill did away with the…

  19. Evansville: A Proactive Approach to Improvement. The Story behind the Indiana State Board of Education's Recent Decision

    ERIC Educational Resources Information Center

    Anderson, Charis

    2014-01-01

    The Indiana State Board of Education (ISBE) has not been shy about exercising its authority to intervene in chronically underperforming schools. Under the state's Public Law 221, the Indiana Board can mandate specific interventions for any school that has received six consecutive failing grades under the state's accountability system--up to a…

  20. Managing Multiple Mandates: A System of Systems Model to Analyze Strategies for Producing Cellulosic Ethanol and Reducing Riverine Nitrate Loads in the Upper Mississippi River Basin.

    PubMed

    Housh, Mashor; Yaeger, Mary A; Cai, Ximing; McIsaac, Gregory F; Khanna, Madhu; Sivapalan, Murugesu; Ouyang, Yanfeng; Al-Qadi, Imad; Jain, Atul K

    2015-10-06

    Implementing public policies often involves navigating an array of choices that have economic and environmental consequences that are difficult to quantify due to the complexity of multiple system interactions. Implementing the mandate for cellulosic biofuel production in the Renewable Fuel Standard (RFS) and reducing hypoxia in the northern Gulf of Mexico by reducing riverine nitrate-N loads represent two such cases that overlap in the Mississippi River Basin. To quantify the consequences of these interactions, a system of systems (SoS) model was developed that incorporates interdependencies among the various subsystems, including biofuel refineries, transportation, agriculture, water resources and crop/ethanol markets. The model allows examination of the impact of imposing riverine nitrate-N load limits on the biofuel production system as a whole, including land use change and infrastructure needs. The synergies of crop choice (first versus second generation biofuel crops), infrastructure development, and environmental impacts (streamflow and nitrate-N load) were analyzed to determine the complementarities and trade-offs between environmental protection and biofuel development objectives. For example, the results show that meeting the cellulosic biofuel target in the RFS using Miscanthus x giganteus reduces system profits by 8% and reduces nitrate-N loads by 12% compared to the scenario without a mandate. However, greater water consumption by Miscanthus is likely to reduce streamflow with potentially adverse environmental consequences that need to be considered in future decision making.

  1. Summer School for the Handicapped: A Review of the Literature. Supplementary Report to "Special Education Mandates: A Preliminary Report."

    ERIC Educational Resources Information Center

    Helmich, Edith

    This report analyzes the literature on the issues involved in providing summer school services to handicapped students (3-21 years old) in Illinois. Introductory sections examine the state legislative history regarding summer school and judicial decisions from across the country on the topic. A review of the literature is presented followed by…

  2. AK State Profile. Alaska: Alaska High School Graduation Qualifying Exam (HSGOE)

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper provides information about Alaska High School Graduation Qualifying Exam (HSGQE), a comprehensive standards-based exam. Its purpose is to meet a state mandate. A bill to remove the HSGQE as a graduation requirement by July 1, 2011 was presented to the state legislature as SB 109. However, it did not pass both houses of the legislature.…

  3. A Study of State Social Studies Standards for American Indian Education

    ERIC Educational Resources Information Center

    Warner, Connor K.

    2015-01-01

    In this study the author surveys social studies standards from 14 U.S. states seeking to answer: (a) what social studies knowledge about American Indians is deemed essential by those states mandating the development of American Indian Education curricula for all public K-12 students? and (b) at what grade levels is this social studies content…

  4. State Insurance Parity Legislation for Autism Services and Family Financial Burden

    ERIC Educational Resources Information Center

    Parish, Susan; Thomas, Kathleen; Rose, Roderick; Kilany, Mona; McConville, Robert

    2012-01-01

    We examined the association between states' legislative mandates that private insurance cover autism services and the health care-related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N = 2,082 children with autism). State policy…

  5. The Children of the State I: A Time for Change in Child Care. Preliminary Report.

    ERIC Educational Resources Information Center

    1975

    This preliminary report of the Temporary State Commission on Child Welfare identifies problems and offers recommendations for improvement in the system of child welfare in New York State. Information about the Commission's mandate and members is followed by a review of the child welfare system in New York. The report indicates that the entire…

  6. NCLB Waivers: Instructions for Secretary Arne Duncan and State Education Bureaucrats

    ERIC Educational Resources Information Center

    Tienken, Christopher H.

    2012-01-01

    The United States Department of Education (USED) granted 11 states waivers (eight full waivers and three conditional waivers) to provide what the USED termed "flexibility" from meeting some of the requirements in the No Child Left Behind Act (NCLB). Much of the flexibility relieves schools from the Adequate Yearly Progress mandate that requires…

  7. Bloodborne Pathogen Control Efforts for Physical Education and Athletic Programs in Southern States.

    ERIC Educational Resources Information Center

    Whiddon, Sue; Horodyski, MaryBeth

    1996-01-01

    Study examined roles assumed by state departments of education in bloodborne pathogen exposure control to protect physical educators and athletic coaches from contracting HIV and hepatitis B. Surveys indicated that 75% of states required written exposure control plans, but many failed to require full compliance with mandated federal guidelines.…

  8. 41 CFR 102-34.280 - What State inspections must we have for Government motor vehicles?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... inspections must we have for Government motor vehicles? You must have the following State inspections for Government motor vehicles: (a) Federally-mandated emissions inspections when required by the relevant State... inspections if the fee is not waived. GSA Fleet will pay the cost of these inspections for motor...

  9. 41 CFR 102-34.280 - What State inspections must we have for Government motor vehicles?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... inspections must we have for Government motor vehicles? You must have the following State inspections for Government motor vehicles: (a) Federally-mandated emissions inspections when required by the relevant State... inspections if the fee is not waived. GSA Fleet will pay the cost of these inspections for motor...

  10. 41 CFR 102-34.280 - What State inspections must we have for Government motor vehicles?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... inspections must we have for Government motor vehicles? You must have the following State inspections for Government motor vehicles: (a) Federally-mandated emissions inspections when required by the relevant State... inspections if the fee is not waived. GSA Fleet will pay the cost of these inspections for motor...

  11. 41 CFR 102-34.280 - What State inspections must we have for Government motor vehicles?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... inspections must we have for Government motor vehicles? You must have the following State inspections for Government motor vehicles: (a) Federally-mandated emissions inspections when required by the relevant State... inspections if the fee is not waived. GSA Fleet will pay the cost of these inspections for motor...

  12. Implications of State Policy Changes on Mental Health Service Models for Students with Disabilities

    ERIC Educational Resources Information Center

    Lawson, Janelle E.; Cmar, Jennifer L.

    2016-01-01

    For over 25 years, students with disabilities in California received educationally related mental health services through interagency collaboration between school districts and county mental health agencies. After a major change in state policy that eliminated state-mandated interagency collaboration, school districts in California are now solely…

  13. Community Participation in Public Schools: Impact of Information Campaigns in Three Indian States

    ERIC Educational Resources Information Center

    Pandey, Priyanka; Goyal, Sangeeta; Sundararaman, Venkatesh

    2009-01-01

    This study evaluates the impact of a community-based information campaign on school performance from a cluster randomized control trial in 610 villages. The campaign consisted of eight or nine public meetings in each of 340 treatment villages across three Indian states to disseminate information to the community about its state-mandated roles and…

  14. NM State Profile. New Mexico: New Mexico High School Competency Examination (NMHSCE)

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper provides information about New Mexico High School Competency Examination (NMHSCE), a minimum competency test. Its purpose is to meet a state mandate. It will be replaced by the Grade 11 Standards Based Assessment/High School Graduation Assessment (SBA/HSGA) in spring 2011 as the state's high school exit exam. The NMHSCE was administered…

  15. Alliance Helps States Map New Terrain in Educator Evaluation. REL West Research Digest

    ERIC Educational Resources Information Center

    Regional Educational Laboratory West, 2014

    2014-01-01

    About five years ago, states across the country took on the huge, complex task of developing and implementing new systems to evaluate teacher and principal performance in public schools. In response to a federal mandate aimed at improving student achievement, especially in the lowest performing schools, state boards of education drafted high-level…

  16. Is the swiss health care system a model for the United States?

    PubMed

    Chaufan, Claudia

    2014-01-01

    Both supporters and critics of the Patient Protection and Affordable Care Act (ACA) have argued that it is similar to Switzerland's Federal Law on Health Insurance (LAMal), which currently governs Swiss health care, and have either praised or condemned the ACA on the basis of this alleged similarity. I challenge these observers on the grounds that they overlook critical problems with the Swiss model, such as its inequities in access, and critical differences between it and the ACA, such as the roots in, and continuing commitment to, social insurance of the Swiss model. Indeed, the daunting challenge of attempting to impose the tightly regulated model of operation of the Swiss model on mega-corporations like UnitedHealth, WellPoint, or Aetna is likely to trigger no less ferocious resistance than a fully public, single-payer system would. I also conclude that the ACA might unravel in ways unintended or even opposed by its designers and supporters, as employers, confronted with ever-rising costs, retreat from sponsoring insurance, and workers react in outrage as they confront the unaffordable underinsurance mandated by the ACA. A new political and ideological landscape may then ensue that finally ushers in a truly national health program.

  17. Comparison of Outcomes before and after Ohio's Law Mandating Use of the FDA-Approved Protocol for Medication Abortion: A Retrospective Cohort Study

    PubMed Central

    Combellick, Sarah L.; Kohn, Julia E.; Roberts, Sarah C. M.

    2016-01-01

    Background In February 2011, an Ohio law took effect mandating use of the United States Food and Drug Administration (FDA)-approved protocol for mifepristone, which is used with misoprostol for medication abortion. Other state legislatures have passed or enacted similar laws requiring use of the FDA-approved protocol for medication abortion. The objective of this study is to examine the association of this legal change with medication abortion outcomes and utilization. Methods and Findings We used a retrospective cohort design, comparing outcomes of medication abortion patients in the prelaw period to those in the postlaw period. Sociodemographic and clinical chart data were abstracted from all medication abortion patients from 1 y prior to the law’s implementation (January 2010–January 2011) to 3 y post implementation (February 2011–October 2014) at four abortion-providing health care facilities in Ohio. Outcome data were analyzed for all women undergoing abortion at ≤49 d gestation during the study period. The main outcomes were as follows: need for additional intervention following medication abortion (such as aspiration, repeat misoprostol, and blood transfusion), frequency of continuing pregnancy, reports of side effects, and the proportion of abortions that were medication abortions (versus other abortion procedures). Among the 2,783 medication abortions ≤49 d gestation, 4.9% (95% CI: 3.7%–6.2%) in the prelaw and 14.3% (95% CI: 12.6%–16.0%) in the postlaw period required one or more additional interventions. Women obtaining a medication abortion in the postlaw period had three times the odds of requiring an additional intervention as women in the prelaw period (adjusted odds ratio [AOR] = 3.11, 95% CI: 2.27–4.27). In a mixed effects multivariable model that uses facility-months as the unit of analysis to account for lack of independence by site, we found that the law change was associated with a 9.4% (95% CI: 4.0%–18.4%) absolute increase in

  18. Mandated Local Health Networks across the province of Québec: a better collaboration with primary care working in the communities?

    PubMed Central

    Maillet, Lara; Haggerty, Jeannie; Vedel, Isabelle

    2014-01-01

    Background In 2004, the Québec government implemented an important reform of the healthcare system. The reform was based on the creation of new organisations called Health Services and Social Centres (HSSC), which were formed by merging several healthcare organisations. Upon their creation, each HSSC received the legal mandate to establish and lead a Local Health Network (LHN) with different partners within their territory. This mandate promotes a ‘population-based approach’ based to the responsibility for the population of a local territory. Objective The aim of this paper is to illustrate and discuss how primary healthcare organisations (PHC) are involved in mandated LHNs in Québec. For illustration, we describe four examples that facilitate a better understanding of these integrated relationships. Results The development of the LHNs and the different collaboration relationships are described through four examples: (1) improving PHC services within the LHN – an example of new PHC models; (2) improving access to specialists and diagnostic tests for family physicians working in the community – an example of centralised access to specialists services; (3) improving chronic-disease-related services for the population of the LHN – an example of a Diabetes Centre; and (4) improving access to family physicians for the population of the LHN – an example of the centralised waiting list for unattached patients. Conclusion From these examples, we can see that the implementation of large-scale reform involves incorporating actors at all levels in the system, and facilitates collaboration between healthcare organisations, family physicians and the community. These examples suggest that the reform provided room for multiple innovations. The planning and organisation of health services became more focused on the population of a local territory. The LHN allows a territorial vision of these planning and organisational processes to develop. LHN also seems a valuable

  19. Clinicians' awareness of the Affordable Care Act mandate to provide comprehensive tobacco cessation treatment for pregnant women covered by Medicaid.

    PubMed

    Tong, Van T; England, Lucinda J; Malarcher, Ann; Mahoney, Jeanne; Anderson, Britta; Schulkin, Jay

    The Affordable Care Act (ACA) requires states to provide tobacco-cessation services without cost-sharing for pregnant traditional Medicaid-beneficiaries effective October 2010. It is unknown the extent to which obstetricians-gynecologists are aware of the Medicaid tobacco-cessation benefit. We sought to examine the awareness of the Medicaid tobacco-cessation benefit in a national sample of obstetricians-gynecologists and assessed whether reimbursement would influence their tobacco cessation practice. In 2012, a survey was administered to a national stratified-random sample of obstetricians-gynecologists (n = 252) regarding awareness of the Medicaid tobacco-cessation benefit. Results were stratified by the percentage of pregnant Medicaid patients. Chi-squared tests (p < 0.05) were used to assess significant associations. Analyses were conducted in 2014. Eighty-three percent of respondents were unaware of the benefit. Lack of awareness increased as the percentage of pregnant Medicaid patients in their practices decreased (range = 71.9%-96.8%; P = 0.02). One-third (36.1%) of respondents serving pregnant Medicaid patients reported that reimbursement would influence them to increase their cessation services. Four out of five obstetricians-gynecologists surveyed in 2012 were unaware of the ACA provision that required states to provide tobacco cessation coverage for pregnant traditional Medicaid beneficiaries as of October 2010. Broad promotion of the Medicaid tobacco-cessation benefit could reduce treatment barriers.

  20. Personality and alcohol-related outcomes among mandated college students: descriptive norms, injunctive norms, and college-related alcohol beliefs as mediators.

    PubMed

    Pearson, Matthew R; Hustad, John T P

    2014-05-01

    The present study examined three alcohol-perception variables (descriptive norms, injunctive norms, and college-related alcohol beliefs) as mediators of the predictive effects of four personality traits (impulsivity, sensation seeking, anxiety sensitivity, and hopelessness) on alcohol use and alcohol-related consequences in a sample of mandated college students (n=875). Our findings replicated several findings of a previous study of incoming freshman college students (Hustad et al., in press) in that impulsivity and hopelessness had direct effects on alcohol-related problems, sensation seeking and impulsivity had indirect effects on alcohol-related outcomes via college-related alcohol beliefs, and college-related alcohol beliefs predicted both alcohol use and alcohol-related problems. We discuss the implications of our findings for global college student interventions as well as personality-targeted interventions.