Author Archives: afscme

Physician Workforce: Locations and Types of Graduate Training Were Largely Unchanged, and Federal Efforts May Not Be Sufficient to Meet Needs

Source: U.S. Government Accountability Office (GAO), GAO-17-411: Published: May 25, 2017

From the summary:
The federal government has reported physician shortages in rural areas; it also projects a deficit of over 20,000 primary care physicians by 2025. Residents in graduate medical education (GME) affect the supply of physicians. Federal GME spending is over $15 billion/year.

We found that, from 2005-15, residents were concentrated in the Northeast and in urban areas. And, while many trained in primary care, primary care residents often subspecialize in other fields. Federal efforts to increase GME in rural areas and primary care were limited. In 2015, we recommended HHS develop a plan for its health care workforce programs—it has yet to do so.

A First Look at Alternative Investments and Public Pensions

Source: Jean Pierre Aubry, Anqi Chen, Alicia Munnell, Center for State and Local Government Excellence, Issue Brief, June 2017

From the summary:
The brief uses data from PublicPlansData.org to explore which state and local pension plans have the largest allocations in investments outside of public equities, bonds, and cash and the broader impact of aggregate allocation shifts on returns and volatility.

The brief’s key findings include:
– Public pension plans have boosted their holdings in alternative assets, defined as private equity, hedge funds, real estate, and commodities.
– This shift reflects a search for higher returns, a hedge for other investment risks, and diversification.
– The question is how the shift has affected returns and volatility over two periods: 2005-2015 and 2010-2015.
– In terms of returns, a 10-percent increase in the average allocation to alternatives was associated with a reduction of 30-45 basis points, primarily due to hedge funds.
– In terms of volatility, alternatives did not have a statistically significant effect. Hedge funds reduced volatility, but real estate and commodities increased it.
– This analysis is only a first look at this area; further research is clearly warranted.

Health, United States, 2016: With Chartbook on Long-term Trends in Health

Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. National Center for Health Statistics, DHHS Publication No. 2017-1232, May 2017

From the highlights:
This Highlights section includes data from the four major areas included in the report: health status and determinants, utilization of health resources, health care resources, and health care expenditures and payers. As Health, United States enters its 40th year of reporting on the health of the nation, this year’s Highlights section presents trends in health from 1975 or the earliest year possible, given data availability and comparability issues. The Highlights focus on both trends and current data on topics of public health interest and illustrate the breadth of material included in Health, United States. Each highlight includes a reference to the detailed trend table or figure where definitions of terms and additional data can be obtained.
Related:
At a Glance
Chartbook
Trend Tables
Appendixes
Index

U.S. Public Pension Plan Contribution Indices, 2006–2014

Source: Lisa Schilling, Society of Actuaries, June 2017

In March 2016, the Society of Actuaries (SOA) introduced contribution indices, metrics that compare pension plan contributions to benchmarks that represent the contribution level needed to pay down unfunded liabilities or to satisfy a specific requirement. This study explores various contribution indices for employer contributions among 160 state and large city public sector pension plans in the United States over 2006-2014 using the assets and liabilities reported under Government Accounting Standards Board (GASB) guidelines. The analysis isolates employer contributions because state law typically defines employee contribution rates, whereas employer contributions are typically more flexible.

Key observations include:
– For 130 plans with consistently viable data for this study over 2006–2014, total unfunded liabilities as reported under GASB guidelines increased about 150% from about $400 billion in 2006 to approximately $1 trillion in 2014, while liabilities increased 47%, from about $2.5 trillion to roughly $3.7 trillion.
– In every year studied, most of the 160 plans with enough data to complete analysis for the year received insufficient employer contributions to maintain their unfunded liabilities— they experienced negative amortization. In 2014, 72% of plans experienced negative amortization, up from 65% in 2006.
– Many plans with negative amortization contributed at least as much as their target contribution. However, at the peak in 2010, 76% of target contributions entailed negative amortization. By 2014, the percentage fell to 67%, roughly the same level as 2006.
– For 2014, 3% of plans showed a funding surplus and 20% of plans received enough employer contributions to fund their shortfall within 30 years without it growing through negative amortization in the meantime.
– Employer contributions for the same 130 plans increased 76%, from about $48 billion in 2006 to roughly $85 billion in 2014. Employee contributions increased 30% during this period, from $28 billion to $37 billion, while payroll and prices both increased 17%…..

Saving Lives in the Stacks How libraries are handling the opioid crisis

Source: Anne Ford, American Libraries, June 21, 2017

…..What Simon didn’t say—but what librarians far and wide know—is that the McPherson Square branch is just one of many American libraries struggling with opioid-related issues such as discarded, contaminated needles; drug use in the library itself; and even on-site overdoses and fatalities. Libraries from California to Colorado, Pennsylvania to Missouri, are finding themselves on the front lines of a battle they never anticipated fighting. Of course, opiate use isn’t limited to libraries. Neither is anyone claiming that the problem is more severe in libraries than it is anywhere else. Still, the fact that libraries are open to all, offer relative anonymity, and generally allow patrons to stay as long as they like make them uniquely vulnerable to those seeking a place to use drugs…..

The opioid epidemic is so bad that librarians are learning how to treat overdoses
Source: Darran Simon, CNN, June 24, 2017

…..Long viewed as guardians of safe spaces for children, library staff members like Kowalski have begun taking on the role of first responder in drug overdoses. In at least three major cities — Philadelphia, Denver and San Francisco — library employees now know, or are set to learn, how to use the drug naloxone, usually known by its brand name Narcan, to help reverse overdoses.

Their training tracks with the disastrous national rise in opioid use and an apparent uptick of overdoses in libraries, which often serve as daytime havens for homeless people and hubs of services in impoverished communities.

In the past two years, libraries in Denver, San Francisco, suburban Chicago and Reading, Pennsylvania have become the site of fatal overdoses…..
Related:
Librarians In Philadelphia Train To Thwart Drug Overdoses
NPR, Weekend Edition, June 3, 2017

The McPherson Branch of the Free Public Library sees almost daily heroin overdoses. NPR’s Scott Simon talks to Mike Newall of the Philadelphia Inquirer and librarian Chera Kowolski about the response.

For these Philly librarians, drug tourists and overdose drills are part of the job
Source: Mike Newall, Philadelphia Inquirer, June 1, 2017

I visited the century-old library that sits atop Needle Park in Kensington because I’d heard its staff was the first in the city to learn how to administer the lifesaving overdose antidote Narcan.

They have been using the spray so often that they can tell the type of overdose simply by the sound coming from the lavatory: Heroin victims slide sluggishly into unconsciousness, the librarians have found, while victims of deadly fentanyl collapse instantly, with a thud that resonates through the entire building, which is called the McPherson Square Branch….

Salt Lake County librarians trained to respond to drug overdoses
Source: Deseret News, June 29, 2017

Salt Lake County Library Services, partnering with the Salt Lake County Health Department, has trained librarians on how to administer Narcan and has distributed naloxone kits to their branches….

Denver Public Library staff equipped with opioid overdose antidote
Source: KDVR, March 17, 2017

Staff at Denver Public Library’s central library are now carrying narcan, an opioid overdose antidote, in response to an increase in people overdosing at the library. …. Fewell said since the library started tracking the incidents in February, staff have counted six overdoses. ….

Fiscal Survey of the States – Spring 2017

Source: National Association of State Budget Officers, June 2017

From the overview:
With data gathered from all 50 state budget offices, this semi-annual report provides a narrative analysis of the fiscal condition of the states and data summaries of state general fund revenues, expenditures, and balances. The spring edition details governors’ proposed budgets; the fall edition details enacted budgets.

Governors’ budgets for fiscal 2018 are extra cautious as states contend with slow revenue growth, limited budget flexibility and substantial federal uncertainty.

Key findings from the report include:
– State general fund spending would increase just 1.0 percent compared to current estimated spending levels under governors’ fiscal 2018 budgets.
– States experienced sluggish general fund revenue growth in fiscal 2017 of 2.4 percent, with 33 states reporting collections below budget projections.
– At least 23 states have already made net mid-year budget cuts totaling $4.9 billion in fiscal 2017.
– General fund revenues are projected to grow 3.1 percent in fiscal 2018 based on governors’ budgets.
– States continue to strengthen their reserves, despite slow revenue growth.
– General fund spending on Medicaid grew at an estimated median rate of 5.2 percent in fiscal 2017, with a median growth rate of 4.3 percent projected for fiscal 2018.
– States that expanded Medicaid expect to spend $8.5 billion from state funds on expansion in fiscal 2018.
– Governors’ proposed tax and fee changes would result in a net increase of $3.7 billion.
Related:
Summary
Archives

How We’re Surviving Right to Work: Letter Carriers Keep Numbers up with Shop Floor Action

Source: Alexandra Bradbury, Labor Notes, June 28, 2017

Postal unions, like all federal employee unions, are open shop. That means workers can get the benefits of union representation while opting out of paying dues.

Yet the postal unions generally maintain high rates of voluntary union membership—and Letter Carriers Branch 82 in Portland, Oregon, does even better than most. From 90 percent membership five years ago, it has “slowly up-ticked,” says Organizing Chair Willie Groshell, to around 95 percent of the 1,200 represented carriers.

How did they raise that number so high? It’s mostly the work of volunteers like Groshell, who delivers the mail full-time. (Three top officers make up the branch’s full-time staff.)

Most new hires sign up right away at orientation, where the branch vice president spends up to two hours with them—the union has this right guaranteed in its contract—talking through the union’s history and what to expect. One perk is getting immediate access to the union’s uniform closet, since the Postal Service won’t provide a uniform allowance until your probation is up…..

Pension burdens to rise through 2020, even in positive investment scenario

Source: Thomas Aaron, Timothy Blake, Moody’s, U.S. Public Finance, Sector In-Depth, June 20, 2017
(subscription required)

A new report gauges pension-related risks in three scenarios for investment returns through fiscal 2020, after adjusted net pension liabilities for US public pension funds surpassed $4 trillion nationwide in 2016.

How much do librarians make? 2017 librarian salary ranges

Source: LibGig, 2017

…..How to determine librarian salary potential
Figuring out library salary ranges involves three steps:
1. Identify potential sources of credible and current salary information.
2. Figure out what job titles those sources are likely to use for the position you’re interested in, and whether what they’re calling, for instance, “data management” is actually what you’d call “records management”.
3. Assess the professional attributes you have and lack that will influence which end of the salary range you’ll likely fall within……

The Relative Returns to Workforce Investment Act–Supported Training in Florida by Field, Gender, and Education and Ways to Improve Trainees’ Choices

Source: Louis Jacobson and Jonathan Davis, Journal of Labor Economics 35, no. S1, July 2017
(subscription required)

From the abstract:
The key finding of this paper is that women Workforce Investment Act (WIA) trainees select higher-return fields than men but men usually have higher returns than women in the same field. Among men, the higher the level of education, the greater the proportion who select high-return fields; the reverse is true for women. Finally, most men select fields that are predominantly male, and vice versa for women, even though gains among men and women making unconventional choices are often large. Thus, there is considerable room for men and women to increase their gains by altering their choice of field.