Category Archives: Human Services

Tracking Federal Funding to Combat the Opioid Crisis

Source: Bipartisan Policy Center, March 2019

From the summary:
In 2017, more than 70,000 people in the United States died from a drug overdose, with almost 50,000 of these deaths involving an opioid. The United States is facing a devastating opioid epidemic, and the federal government has responded by investing billions of dollars into prevention, treatment, and recovery efforts over the past two years. This includes efforts to curb the supply of both illicit opioids and unnecessary prescription opioids and to improve access to evidence-based treatment for opioid use disorder. Despite these actions, addiction policy experts believe that the end of the epidemic is not yet in sight.

Considerable attention has focused on the drivers of the opioid epidemic. However, less attention has been paid to whether the federal investments to address the issue are being effectively targeted to the communities most affected and to those with the highest overdose deaths. An effective response requires policymakers to know how resources are allocated and to use that information to minimize duplication and maximize the efficiency of limited resources. The federal government has not previously produced or made available a document that provides this information to the public or policymakers.

Corporations and the American Welfare State: Adversaries or Allies?

Source: Mark S. Mizruchi, Studies in American Political Development, FirstView, Published online: February 18, 2019
(subscription required)

One of the most widely held views about American political life is that business is hostile to the welfare state. In the 1970s, David Vogel asked why American businessmen “distrusted their state.” Kim Phillips-Fein has written of the “businessmen’s crusade against the New Deal.” Jane Mayer and Nancy MacLean have recounted the efforts of the Koch Brothers and their wealthy allies to remake American politics in a more conservative direction. What could be more uncontroversial than the view that American business is broadly opposed to government social policies?

Related:

Ascertaining Business’s Interests and Political Preferences
Source: David E. Broockman, Studies in American Political Development, FirstView, Published online: February 26, 2019
(subscription required)

Medicare is one of the largest social programs in the world. Did organized industry favor Medicare’s passage in 1965? If it did, this would represent powerful evidence in favor of the theory that social programs typically require cross-class alliances to pass, such as alliances between business and labor. However, in a previous article in this journal, I argued that answering questions about political actors’ preferences—such as whether organized industry favored Medicare’s passage—can be surprisingly difficult due to the “problem of preferences”; that is, political actors might misrepresent their true policy preferences for many reasons. For example, when their ideal proposals are not politically feasible, political actors may wish to bolster support for a more politically viable alternative to a disliked proposal—even if they do not truly support this alternative to the status quo. To better understand political actors’ true policy preferences, I argued, scholars should trace how those actors’ expressed preferences change as a function of their strategic context—just as scholars seeking to understand the impact of any other variable trace the effects of changes in it.

Business Interests and the Shape of the U.S. Welfare State: From the Insurance Company Model to Comprehensive Reform
Source: Christy Ford Chapin, Studies in American Political Development, FirstView, Published online: February 18, 2019
(subscription required)

Peter Swenson’s excellent article is a welcome correction to the consensus argument so often found in welfare state literature. That interpretation depicts a never-ending, dualistic struggle between capitalists and “the people,” as represented by welfare reformers. Swenson sorts through the evidence surrounding post-1960 health care debates, particularly Medicare, to demonstrate that “business” is not a fixed, homogeneous group that conforms neatly to class-based analysis. He finds significant business backing for federal programming and also shows that where trade associations took conservative, anti-reform stands, they often did so without strong member support.

“Mom, When They Look at Me, They See Dollar Signs” How rehab recruiters are luring recovering opioid addicts into a deadly cycle.

Source: Julia Lurie, Mother Jones, March/April 2019

….The addiction community has a name for what happened to Brianne. It’s called the “Florida shuffle,” a cycle wherein recovering users are wooed aggressively by rehabs and freelance “patient brokers” in an effort to fill beds and collect insurance money. The brokers, often current or former drug users, troll for customers on social media, at Narcotics Anonymous meetings, and on the streets of treatment hubs such as the Florida coast and Southern California’s “Rehab Riviera.” The rehabs themselves exist in a quasi-medical realm where evidence-based care is rare, licensed medical staffers are optional, conflicts of interest are rampant, and regulation is stunningly lax.

While experts say the practices described in this story are widespread, it is important to note that there are plenty of responsible treatment providers, and not all the facilities named engage in all the practices described. Recovery Villas, which was raided by Florida authorities last summer on suspicion of insurance fraud and is now under investigation by the state, did not respond to my questions. A Compass Detox spokesman said that paying clients for treatment and giving them drugs between rehab stints “is illegal and we don’t do that.” Compass obeys all relevant laws and regulations, he emphasized…..

Library Systems Embracing Their New Roles As Social Service Hubs

Source: Emily Nonko, Next City, January 22, 2019

…. Starting from Esguerra, the San Francisco Public Library now has a team of Health and Safety Associates (now known as HASAs) who use the bathrooms as outreach space. HASAs have since expanded their work outside bathrooms and provide outreach on all seven floors of the main branch. They also work at other branches to support staff and inform patrons about resources and services. The program has placed at least 130 patrons into stable housing, Esguerra says.

San Francisco’s experience directly inspired change at the Denver Public Library. In 2012, the Homeless Services Action Committee — an internal working group with the Denver library — made recommendations to add a social worker to staff. The library eventually hired social worker Elissa Hardy in 2015 to begin building the library’s Community Resource program, bringing on additional social workers and peer navigators. The program has gone from serving 434 library customers in 2015, when it was just Hardy, to 3,500 served in 2018.

Both the San Francisco and Denver programs have grown as affordable housing needs and homelessness increase in each city. The San Francisco Public Library budgeted to hire six HASAs this year; currently, five work with Esguerra. For 2019, Denver Public Library budgeted for a team of 10, including four social workers and six peer navigators — the team now covers all 26 locations within the Denver Public Library. ….

State-level data for understanding child welfare in the United States

Source: Child Trends, February 26, 2019

High-quality data can provide public officials and advocates with crucial details about the populations they serve. State-level data for understanding child welfare in the United States is a comprehensive resource, including easy-to-use interactive features, that provides state and national data on child maltreatment, foster care, kinship caregiving, and adoption. This resource compiles critical data from a variety of sources on children, youth, and families who came in contact with the child welfare system in federal fiscal year (FY) 2017.

These data are important because they help policymakers understand how many children and youth came in contact with the child welfare system, and why. States can also use this information to ensure their child welfare systems support the safety, stability, and well-being of all families in their state.

Shrinking local autonomy: corporate coalitions and the subnational state

Source: Yunji Kim, Mildred E Warner, Cambridge Journal of Regions, Economy and Society, Volume 11, Issue 3, October 2018
(subscription required)

From the abstract:
Using focus groups and government finance data, we explore three areas of US state rescaling at the subnational level: revenue tools, expenditure responsibilities and policy authority. Expenditure responsibilities, especially social welfare, have been devolved to the subnational level, while local revenue tools and policy authority are preempted. This decoupling of responsibility and power is cracking the foundations of fiscal federalism. At the behest of corporate-legislative coalitions, subnational state governments are shrinking local capacity and authority to govern. This is not state shrinkage; it is a fundamental reshaping of the subnational state to the detriment of democracy and the social contract.

How Government and Community Nonprofit Collaboration and Non-Collaboration Affects Public Sector Outcomes

Source: Rebecca H. Padot, International Journal of Public Administration, OnlineFirst, February 15, 2019
(subscription required)

From the abstract:
This four state foster care study seeks to understand what practices state public managers perform with regards to community nonprofits that contributes to effectiveness in producing better public sector outcomes. The study produced key player field research data on the conditions under which community nonprofits produce better public sector outcomes.

This article offers reasons as to why some effective community nonprofits were able to achieve collaboration with the public sector, while others were not, despite their effectiveness. Effective public managers in the area of foster care administration permit, and at times recruit, community nonprofits to have an impact on their foster care domain, while ineffective public managers never reach out to community nonprofits as partners or further yet, block nonprofits from access.

Other Duties as Assigned: Front-line librarians on the constant pressure to do more

Source: Anne Ford, American Libraries, January 2, 2019

Maybe it existed only in our collective imagination—the era when librarians focused solely on providing access to written information, and when their greatest on-the-job challenge consisted of keeping the stacks in order. Whether that halcyon time ever actually took place, it’s definitely not here now. Social worker, EMT, therapist, legal consultant, even bodily defender: These are the roles that many (perhaps most?) librarians feel they’re being asked to assume.

American Libraries asked seven librarians—public, academic, and school; urban and rural—their thoughts about the many directions in which their profession finds itself pulled….

Local Labor Demand and Program Participation Dynamics: Evidence from New York SNAP Administrative Records

Source: Erik Scherpf, Benjamin Cerf, Journal of Policy Analysis and Management, Early View, First published: January 8, 2019
(subscription required)

From the abstract:
This study estimates the effect of local labor demand on the likelihood that Supplemental Nutrition Assistance Program (SNAP) beneficiaries are able to transition out of the program. Our data include SNAP administrative records from New York (2007 to 2012), linked at the person‐level to the 2010 Census, and linked at the county‐month‐level to industry‐specific labor market conditions. We find that local labor markets matter for the length of time spent on SNAP, but there is substantial heterogeneity in estimated effects across local industries. Using Bartik‐style instruments to isolate the effect of labor demand and controlling for the changing composition of entrants and program rules brought on by the Great Recession, we find that fluctuations in labor demand in industries with high shares of SNAP participants—especially food service and retail—change the likelihood of exiting the program. Notably, estimated industry effects vary across race and parental status, with black participants being most sensitive to changes in local labor market conditions and mothers benefiting less from growth in local labor demand than fathers and non‐parents. We confirm that our results are not driven by endogenous inter‐county mobility or New York City labor markets and are robust to multiple specifications.

The 2019 government shutdown is just the latest reason why poor people can’t bank on the safety net

Source: Jamila Michener, The Conversation, January 14, 2019

….People living in poverty are now bracing for that kind of chopping as a result of the partial government shutdown that began in December. By the three-week mark, most safety-net benefits were still being funded. But should the impasse drag on, that could change.

In my view, the added economic hardship brought on would highlight an enduring aspect of American public policy: Government benefits can be unreliable. They can be cut or eliminated arbitrarily….