Author Archives: afscme

Immunizing health care workers against influenza: A glimpse into the challenges with voluntary programs and considerations for mandatory polices

Source: Susan Quach, Jennifer A. Pereira, Jeffrey C. Kwong, Sherman Quan, Lois Crowe, Maryse Guay, Julie A. Bettinger, American Journal of Infection Control, Article in Press, August 23, 2013
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From the abstract:
Vaccination of health care workers (HCWs) is an important patient safety initiative. It prevents influenza infection among patients and reduces staff illness and absenteeism. Despite these benefits, HCW influenza immunization uptake is low. Therefore, strategies to achieve high immunization coverage in HCWs, barriers to uptake, and perceptions of mandatory influenza immunization policies were discussed in key informant interviews with influenza immunization program planners…. Participants used a variety of promotional and educational activities, and many vaccine delivery approaches, to support HCW immunization programs. Barriers to achieving high coverage in HCWs included misconceptions about the safety and effectiveness of the influenza vaccine, negative personal experiences associated with the vaccine, and antivaccine sentiments. Participants mentioned mandatory influenza immunizations as a solution to low coverage. However, they identified challenges with this approach such as obtaining support from stakeholders, enforcement, and limiting personal autonomy….
Participants believed immunization coverage in health care organizations will continue to be suboptimal using existing program strategies. Although participants discussed mandatory immunization as a way to improve uptake, potential obstacles will need to be addressed for this to be implemented successfully.

Mortality in Local Jails and State Prisons, 2000-2011 – Statistical Tables

Source: Scott Ginder, Margaret Noonan, U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, NCJ 242186, August 13, 2013

From the abstract:
Presents national and state-level data on the number of inmate deaths that occurred in local jails and state prisons, how the deaths are distributed across jails, and an aggregate count of deaths in federal prisons. The report presents annual counts and 12-year trends between 2000 and 2011 for deaths in custody. It provides mortality rates and moving averages per 100,000 inmates in custody of jail or prison; details cause of death, including deaths attributed to homicide, suicide, illness, intoxication, and accidental injury; describes decedents’ characteristics, including age, race or Hispanic origin, sex, legal status, and time served; and specifies the state where the deaths occurred. Data sources include the Bureau of Justice Statistics’ Deaths in Custody Reporting Program (DCRP), initiated in 2000 under the Death in Custody Reporting Act of 2000 (P.L. 106-297), and the National Prisoner Statistics series.

Highlights:
– After a decline in 2008, the mortality rate for jail inmates has remained relatively stable (125 deaths per 100,000 inmates in 2010 and 122 per 100,000 in 2011).
– Males and females died at nearly equal rates in local jails in 2011.
– In 2011, 8 in 10 jails (81%) reported zero deaths to the DCRP. From 2000 to 2011, an annual average of 82% of jails reported zero deaths.
– Between 2001 and 2011, the female prisoner mortality rate fluctuated from 127 to 172 deaths per 100,000 female prisoners. In 2011, the male prisoner mortality rate was 1.6 times higher than the female prisoner mortality rate.
– The cancer mortality rate increased for both male (up 22%) and female (up 79%) prisoners from 2002 to 2010. The cancer mortality rate for female prisoners showed the greatest increase, from 26 deaths per 100,000 in 2002 to 47 deaths per 100,000 in 2010.
See also:
Press Release
ASCII file
Comma-delimited format (CSV)

A Framework for Restructuring the Military Retirement System

Source: Roy A. Wallace, Lieutenant Colonel David S. Lyle, Dr. John Z. Smith, Strategic Studies Institute, U.S. Army War College, ISBN 1-58487-580-1, July 2013

The current military retirement system has been integral to sustaining the All Volunteer Force (AVF). Mounting federal budget challenges, however, have raised concern that the program may become fiscally unsustainable. While several restructuring proposals have emerged, none have considered the implications of these changes to the broader issue of manning an AVF. Changes to the existing system could create military personnel shortfalls, adversely affect servicemember and retiree well-being, and reduce public confidence in the Armed Forces. With the right analytical framework in place, however, a more holistic system restructuring is possible, one that avoids these negative effects while significantly reducing costs. A comprehensive framework is provided, as well as a proposal that stands to benefit both servicemembers in terms of value and the military in terms of overall cost savings. …Our proposal is called the 10-15-55 plan. Service members and the military contribute to a 401(k) account as soon as they enter service. At any point, a service member may leave the military with his or her contributions to the 401(k). At 10 years of service, the service member controls 50 percent of what the military contributed to the 401(k). That percentage increases by 10 percentage points each year for 5 years until the service member reaches 15 years of service, at which time the service member controls 100 percent of employer contributions. In addition to the 401(k) account, service members who continue to 20 years of service also receive the DB pension plan as it currently exists, with the exception that they may not receive payments until they turn 55 years of age. While all current service members would be grandfathered under the existing pension system, new entrants would be covered by the 10-15-55 proposal. The 10-15-55 proposal would likely be more desirable to new entrants than the existing pension plan because of the uncertainty that most new recruits face about serving a full 20-year career. When evaluated against the pension framework provided in this monograph, the 10-15-55 pension proposal has many attractive features. …
See also:
Abstract
Executive Summary

Interventions for Adult Offenders With Serious Mental Illness

Source: Joann Fontanarosa, Stacey Uhl, Olu Oyesanmi and Karen M Schoelles, Agency for Healthcare Research and Quality, Report No.: 13-EHC107-EF, August 2013

From the abstract:
…We identified some promising treatments for individuals with serious mental illness during incarceration or during transition from incarceration to community settings. Treatment with antipsychotics other than clozapine appears to improve psychiatric symptoms more than clozapine in an incarceration setting. Two interventions, discharge planning with Medicaid-application assistance and integrated dual disorder treatment programs, appear to be effective interventions for seriously mentally ill offenders transitioning back to the community. The applicability of our findings may be limited to the populations and settings in the included studies….

Language Use in the United States: 2011

Source: Camille Ryan, U.S. Census Bureau, American Community Survey Reports, ACS-2, August 2013

…The primary purpose of the current questions on language use is to measure the portion of the U.S. population that may need help in understanding English. These data are used in a wide variety of legislative, policy, and research applications as well as for legal, financial, and marketing decisions. People who speak a particular language other than English and cannot speak English “very well” can be helped with translation services, education, or assistance in accessing government services. The federal government uses data on language use and English-speaking ability to determine which local areas must provide language-assistance services under the Voting Rights Act. These data are also used to allocate educational funds to states to help their schools teach students with lower levels of English proficiency. In 2000, President Clinton signed an executive order requiring federal agencies to identify the need for services to those with limited English proficiency (LEP) and to implement a system to provide meaningful access to language-assistance services. Agencies rely on these data to determine how and where to provide language- assistance services. 2 Many other institutions, organizations, local governments, and private enterprises make use of these data in similar ways….

This report relies primarily on data from the 2011 ACS. Language and English-speaking ability questions that were historically collected once every 10 years in the decennial census are now captured annually in the ACS. The ACS collects information from a large annual sample of approximately 3 million housing unit addresses and therefore provides more reliable statistics. The ACS is administered to a sample of the entire resident population, including those living in group quarters, which makes most estimates from the ACS comparable with those from earlier censuses. 3 Taking advantage of this fact, the report also provides a historical look at languages other than English spoken in the United States since 1980. The report also looks at characteristics of the population speaking a language other than English. The ACS also provides reliable estimates for small levels of geography, including counties, cities, and tracts, allowing exploration of the distribution of language use across states and metropolitan areas of the United States…
See also:
Interactive Language Mapper

Evaluating the Effectiveness of Correctional Education: A Meta-Analysis of Programs That Provide Education to Incarcerated Adults

Source: Lois M. Davis, Robert Bozick, Jennifer L. Steele, Jessica Saunders, Jeremy N. V. Miles, RAND Corporation, ISBN: 978-0-8330-8108-7, 2013

From the press release:
Attorney General Eric Holder and Secretary of Education Arne Duncan today announced research findings showing that, on average, inmates who participated in correctional education programs had 43 percent lower odds of returning to prison than inmates who did not. Each year approximately 700,000 individuals leave federal and state prisons; about half of them will be reincarcerated within three years. The research, funded by the Justice Department’s Bureau of Justice Assistance, was released today by the RAND Corporation…. The findings, from the largest-ever analysis of correctional educational studies, indicate that prison education programs are cost effective. According to the research, a one dollar investment in prison education translates into reducing incarceration costs by four to five dollars during the first three years after release, when those leaving prison are most likely to return….With funding from The Second Chance Act (P.L. 110-199) of 2007, the RAND Corporation’s analysis of correctional education research found that employment after release was 13 percent higher among prisoners who participated in either academic or vocational education programs than among those who did not. Those who participated in vocational training were 28 percent more likely to be employed after release from prison than those who did not receive such training….

Smart on Crime: Reforming the Criminal Justice System for the 21st Century

Source: United States Department of Justice, Office of the Attorney General, August 2013

The initial package of reforms described below —dubbed the Justice Department’s “Smart on Crime” initiative — is only the beginning of an ongoing effort to modernize the criminal justice system. In the months ahead, the Department will continue to hone an approach that is not only more efficient, and not only more effective at deterring crime and reducing recidivism, but also more consistent with our nation’s commitment to treating all Americans as equal under the law. We of course must remain tough on crime. But we must also be smart on crime.

Five Principles of “Smart on Crime”
1. Prioritize Prosecutions To Focus on Most Serious Cases
2. Reform Sentencing to Eliminate Unfair Disparities and Reduce Overburdened Prisons
3. Purse Alternatives to Incarceration for Low-Level, Non-Violent Crimes
4. Improve Reentry to Curb Repeat Offenses and Re-victimization
5. ‘Surge’ resources to Violence Prevention and Protecting Most Vulnerable Populations

Detroit’s Pension Problems: Not as Bad as They’re Portrayed

Source: Monique Morrissey, Economic Policy Institute, Working Economics blog, August 1, 2013

Detroit’s emergency manager, Kevyn Orr, claims Detroit owes $3.5 billion to its public pension funds. This is more than five times the $640 million the funds’ actuaries estimated in 2011, vaulting pensioners into the ranks of the city’s major creditors, which isn’t a good place to be. It also contributes to Orr’s claim that Detroit owes a total of $18 billion—half to retirees and workers—and that bankruptcy is the city’s only recourse….
Related:
Inflating Detroit’s Pension Liabilities, Part 2
Source: Monique Morrissey, Economic Policy Institute, Working Economics blog, August 5, 2013

Detroit: Pensions, Racism and Bankruptcy
Source: Ross Eisenbrey, Economic Policy Institute, Working Economics blog, August 5, 2013

Detroit’s current citizens and the public employees who serve them are not the cause of Detroit’s fiscal problems. They are the victims of forces beyond their control, including globalization, capital flight and racism. No one can, with any seriousness, blame Detroit’s librarians, social workers, garbage collection workers or street cleaners for the city’s catastrophic loss of population and tax base, the long decline and near-collapse of the Big 3 auto companies, or the 1967 riots, which launched a frantic exodus of businesses, white residents, and money from the City of Detroit to the suburbs….

The Federal Minimum Wage: In Brief

Source: David H. Bradley, Congressional Research Service (CRS), CRS Report for Congress, R43089, May 30, 2013

The Fair Labor Standards Act (FLSA), enacted in 1938, is the federal legislation that establishes the minimum hourly wage that must be paid to all covered workers. The minimum wage provisions of the FLSA have been amended numerous times since 1938, typically for the purpose of expanding coverage or raising the wage rate. Since its establishment, the minimum wage rate has been raised 22 separate times. The most recent change was enacted in 2007 (P.L. 110-28), which increased the minimum wage to its current level of $7.25 per hour.

In addition to setting the federal minimum wage rate, the FLSA provides for several exemptions and subminimum wage categories for certain classes of workers and types of work. Even with these exemptions, the FLSA minimum wage provisions still cover the vast majority of the workforce. Despite this broad coverage, however, the minimum wage directly affects a relatively small portion of the workforce. Currently, there are approximately 3.6 million workers, or 4.7% of all hourly paid workers, whose wages are at or below the federal minimum wage of $7.25 per hour. Approximately three-quarters of minimum wage workers are age 20 or older and nearly two-thirds work part time.

Proponents of increasing the federal minimum wage argue that it may increase earnings for lower income workers, lead to reduced turnover, and increase aggregate demand by providing greater purchasing power for workers receiving a pay increase. Opponents of increasing the federal minimum wage argue that it may result in reduced employment or reduced hours, lead to a general price increase, and reduce profits of firms paying a higher minimum wage.

The Fair Labor Standards Act (FLSA): An Overview

Source: Gerald Mayer, Benjamin Collins, David H. Bradley, Congressional Research Service (CRS), CRS Report for Congress, R42713, June 4, 2013

The Fair Labor Standards Act (FLSA) provides workers with minimum wage, overtime pay, and child labor protections. The FLSA covers most, but not all, private and public sector employees. In addition, certain employers and employees are exempt from coverage.

Provisions of the FLSA that are of current interest to Congress include the basic minimum wage, subminimum wage rates, exemptions from overtime and the minimum wage for persons who provide companionship services, the exemption for employees in computer-related occupations, compensatory time (“comp time”) in lieu of overtime pay, and break time for nursing mothers.

Basic Minimum Wage
• The FLSA requires employers to pay covered, nonexempt employees at least the minimum wage. In 2007, the basic minimum wage was raised, in steps, from $5.15 to $7.25 an hour. The basic minimum wage was raised to $7.25 an hour effective July 24, 2009. As of January 1, 2013, 19 states and the District of Columbia have minimum wage rates that are higher than the federal minimum wage rate.
• Basic minimum wage rates in American Samoa and the Commonwealth of the Northern Mariana Islands (CNMI) are lower than in the continental United States. In 2007, Congress passed the Fair Minimum Wage Act of 2007 (P.L. 110- 28), which mandated annual increases of $0.50 an hour in the minimum wages of American Samoa and CNMI. In 2010, Congress temporarily suspended these increases. The minimum wage in CNMI increased by $0.50 an hour to $5.55 on September 30, 2012. In July 2012, Congress delayed the increases in American Samoa. The next minimum wage increases in American Samoa are scheduled for September 30, 2015.

Subminimum Wage Rates
• Tipped employees may be paid less than the basic minimum wage, but their cash wage plus tips must equal at least the basic minimum wage of $7.25. Employers may pay tipped workers $2.13 an hour in cash wages, provided the employees receive at least $5.12 an hour in tips. The latter amount is called a “tip credit.”
• Employers may pay special minimum wages (SMWs) to workers with disabilities. The purpose of the SMWs is to provide persons with disabilities the opportunity to work.

Overtime
• The FLSA requires employers to pay at least time-and-a-half to covered, nonexempt employees who work more than 40 hours in a week at a given job.
• The FLSA allows covered, nonexempt state and local government employees to receive compensatory time off (comp time) for hours worked over 40 in a workweek. Comp time is time off with pay in lieu of overtime pay.

Exemptions
• The FLSA exempts certain employers and employees from the minimum wage, overtime pay, or child labor standards of the act.
• Certain employees in computer-related occupations are exempt from both the minimum wage and overtime standards of the FLSA if they meet an hourly wage or weekly salary test and a job duties test.

Domestic service workers who provide companionship services in private homes are exempt from both the minimum wage and overtime requirements of the FLSA. Under regulations proposed by the U.S. Department of Labor (DOL), minimum wage and overtime coverage would be extended to companions employed by a third party. Overtime pay would be extended to live-in domestic service workers employed by a third party.