SAMHSA urges treatment programs to test for HIV

Last month, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) called on public health and substance use disorder (SUD) treatment providers to help make sure patients who are negative for human immunodeficiency virus (HIV) stay that way, and that those who are HIV‐positive are tested, receive antiretroviral treatment and stay “adherent” to the treatment. The directive came in the form of a “Dear Colleague Letter” from SAMHSA Director Elinore F. McCance‐Katz, M.D., Ph.D., assistant secretary for mental health and substance use for the Department of Health and Human Services.     

NASADAD to NIDA: Connect research to practice

When the National Institute on Drug Abuse (NIDA) sought input on its five‐year plan, the people responsible for publicly funded prevention, treatment and recovery — state directors — called for returning to the days of communication between federal agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) and between NIDA researchers and the service delivery system. In an Aug. 7 letter to NIDA's strategic planning team, Robert I.L. Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD), noted that each state alcohol and drug agency has a critical role to play in NIDA initiatives. This role includes.     

SAMHSA pushes back against ‘political ploy’ criticism

Last week, the Substance Abuse and Mental Health Services Administration (SAMHSA) struck back against “members of the media and even other federal agencies who purportedly exist to protect the health of Americans,” charging that children's mental health is the agency's main reason for promoting school reopenings. The Sept. 29 statement by SAMHSA ( https://www.samhsa.gov/newsroom/press‐announcements/202009290204 ) came the day after the New York Times article ( https://www.nytimes.com/2020/09/28/us/politics/white‐house‐cdc‐coronavirus‐schools.html ) revealing the federal Centers for Disease Control and Prevention's (CDC's) concerns about reopening schools.     

‘Doing Something Meaningful’: Gender and Public Service during Municipal Government Restructuring

Research on the gendered dimensions of workplace restructuring often focuses on management strategies and their structural consequences. Less attention is paid to employees’ gendered practices. In this article, we analyse material from in‐depth interviews with front‐line public‐sector employees following a major reorganization of their jobs and workplaces. Our study makes three contributions to theory and research on gender and organizational change. Firstly, it highlights the micro‐level dynamics at the heart of restructuring by showing how workers engaged with an ideal that was central to their understanding of public‐sector work — the public‐service ethic — which they believed was threatened. Secondly, it highlights the importance of gendered meanings and identities in shaping how workers engaged with the public service ethic. Thirdly, the study shows that front‐line employees did not passively accept management plans for change but struggled to resist or transform them in gendered strategies for dealing with organizational change.     

Psychotropic medication management for youth in state care: consent, oversight, and policy considerations

The use of psychotropic medications in youth with emotional disturbances in state custody is increasing and presents unique challenges concerning consent and oversight. We examine various means that state child welfare agencies use to provide consent for and oversight of psychotropic medications for children in state custody and describe benefits of a consent process that provides for expert consultation to the child welfare agency and prescribing clinicians, case-specific and systemic oversight of psychotropic medication use, and education for stakeholders.     

DEA,SAMHSA relax OTP/OBOT regulations due to COVID‐19

Opioid treatment programs (OTPs) that dispense methadone got a fast and clear reprieve from federal authorities last week in the face of COVID‐19. The Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) issued policies that give OTPs flexibility in take‐homes, limiting the frequency of face‐to‐face contact and opportunities for transmission of COVID‐19. There is also greater flexibility for office‐based opioid treatment (OBOT) with buprenorphine.     

Toward an effective treatment system for adolescents with substance use disorders: The role of the states

A 2002 national expert panel found that the treatment system for adolescents with substance use disorders was inadequate and underdeveloped. The panel recommended immediate improvement in five areas: youth-serving agency collaboration, treatment system financing, workforce development, the implementation of evidence-based practices, and family involvement in all aspects of treatment. In 2004, the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA), designed the State Adolescent Substance Abuse Treatment Coordination Grant program (SAC) and implemented it in 2005 to address the critical need in the field. This paper reviews the adolescent substance use disorders treatment system, discusses selected drivers for change and the design of the SAC grant program, and summarizes some of the program's results. Both quantitative and qualitative data analysis document that substantive systems development occurred within each of the sixteen grantees and that federal–state partnerships are useful in creating systemic change.     

The future of public sector unionism in the United States

The future of nonpublic safety, non-teacher, non-federal public sector unions is bright. As a result of past success, the unions, led by AFSCME, have an organizing culture and sufficient power within the sector to maintain and increase density. However, the challenges that lie ahead in the 21st century will surely test the strength of AFSCME and the other public service unions. The large gains in public employee membership achieved in the last third of the 20th century are not likely to come with the relative ease with which they were achieved during that period. The remaining unorganized workers are in locations and occupations that have not been historically fertile ground for unions, public or private. In addition, the threat of privatization of jobs requires public unions to re-think their traditional strategies and organize in the more hostile private sector while simultaneously protecting the public sector from attacks. The public sector unions recognize that they have a tenuous grasp on their relatively strong position and must organize to maintain and strengthen their position. Absent dramatic changes in federal private sector labor law, and adoption of numerous public sector labor laws, the resources necessary for organization will be tremendous. The future is bright for the public sector unions only because they have demonstrated a willingness to adapt to change, make sacrifices, and deploy sufficient resources to achieve growth. The views herein are the author’s and do not necessarily represent the views of AFSCME.     

Study: Elevated risk of substance use if parents use marijuana

Last month, JAMA Network Open published a study indicating that recent and past parental marijuana use confers a heightened risk for use of marijuana — and other substances — by their adolescent and young adult offspring who live in the same household. The article from the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Drug Abuse and McLean Hospital is in line with federal anti‐marijuana policy (marijuana is still illegal under federal law, although states have legalized it, both recreationally, in some cases, and medically, in more).     

Inter‐State Disparities in Health Outcomes in Rural India: An Analysis Using a Stochastic Production Frontier Approach

In an era of reforms in the health sector and with the role of government in health provision diminishing, emphasis is shifting to making the sector efficient. This article analyses the performance of the rural public health systems of 16 major States in India, using stochastic production frontier techniques and panel data for the period 1986‐97. The results show that States differ not only in capacity‐building in terms of health infrastructure created, but also in efficiency in using these inputs. There is scope for health systems to re‐orient their strategies in order to provide the best health in the most efficient way or at the lowest possible cost.     

Creating Foster Care Youth Biographies: A Role for the Internet

ABSTRACT

Large numbers of youth continue to enter foster care despite federal and state efforts to minimize placement. Some youth will experience lengthy tenure in care with multiple placements and be at risk for adverse events. They are also at risk for losing an accurate biography of their childhoods. We suggest a two-tiered approach to help youth develop a personal history. Agencies can establish a digital depository of basic information including pictures that document the life course of the youth. Agencies can help youth procure e-mail accounts. These e-mail accounts are under the control of the youth and can function as an electronic diary. Thus, youth would have a portable life biography and sense of self over time.     

Public employee unions and the privatization of “public” services

Public sector unions are strongly opposed to contracting with the private sector for the production of goods and services. Economic theory indicates that because of incentives the private sector should be much more efficient that the public sector — a proposition verified for numerous activities of state and local governments. This paper examines evidence at the federal level to show that substantial cost savings can be achieved by contracting out in that sector as well.     

Organizations advocating for youth: the local advantage

Youth occupy a unique place in our democratic society. They must primarily rely on others to speak on their behalf as decisions are made about the allocation of resources within and across various youth-serving institutions. Advocacy organizations comprise crucial representational assets for all youth, but America's poorest children and youth especially need an effective voice to speak for and about them. Yet advocates for youth in urban areas face tough challenges since urban voters typically have few positive connections to youth. This article draws on three years of research focused on three organizations in the San Francisco Bay Area that have successfully advocated for better policies for youth. The authors explore the strategies that these organizations have employed to overcome the challenges they face, with particular attention to the advantages that follow from advocating at the local rather than at the state or federal level.     

Are partnership boards really valuing people?

Observations were conducted in three county councils to find out whether the government’s ambition to develop Learning Disability Partnership Boards (as expressed in the White Paper Valuing people) are being realized. All the partnerships practiced various inclusive activities in order to involve people with learning disabilities in public service strategies. However, there appeared to be limited opportunities for citizens to be involved in recommendations or decision‐making for their area. This concurs with other research elsewhere on the involvement of citizens in state provision, i.e. public participation in civic affairs remains in the control of public sector managers. The lack of opportunities for citizens to direct the allocation of resources and strategies at a local level, regardless of their ability to process information, emphasises the limits of New Labour’s citizen–public sector partnerships.     

Exploring the link between government funding and efficiency in nonprofit colleges

Previous literature has suggested that federal funding can hinder the efficiency of nonprofit organizations, but this has yet not been empirically tested. This study used a two‐stage data envelopment analysis (DEA) model to measure the efficiency of a set of private nonprofit teaching‐oriented colleges, then estimate the impact of federal and state funding on organizational efficiency. The findings indicate that, on average, increases in neither state nor federal funding effect efficiency of nonprofit colleges. Increasing state funding negatively impacted the efficiency of public colleges (N = 799). This study suggests that the challenges for nonprofits that accompany government funding may not rise to a quantifiable negative effect on efficiency.     

Human capital inflow in nonprofits: Entry‐level employees’ sector shift

Although recruitment and retention of qualified employees are some of the biggest challenges in the nonprofit sector, nonprofit organizations must maintain human capital inflow due to its significant impacts on organizational success. Through person‐organization value fit, this paper explores the factors that influence labor shifts from the public or for‐profit sector into the nonprofit sector in the South Korean context. Specifically, the effects on the likelihood of employees switching to the nonprofit sector from the perspective of eight job satisfaction measures and three education–job match measures are investigated. Two groups of employees (those whose career started in the for‐profit sector and those starting in the public sector) are compared. Results indicate that there is substantial variation between the two groups. In particular, intrinsic job satisfaction has completely different effects on those working in the for‐profit sector than on those working in the public sector regarding their likelihood of having experienced an intersectoral shift into nonprofits. The more public employees are satisfied with intrinsic job rewards, especially job reputation, the more likely they are to move to nonprofits. These results suggest that when employees in the public sector are satisfied with intrinsic rewards they tend to pursue greater intrinsic satisfaction in the nonprofit sector. This paper also reports that education–job match is only significant for those whose first job was in the for‐profit sector.     

Four Documents,a Non‐Citizen,and a Diplomatic Controversy: The Documentation of Identity in the Mid‐Nineteenth Century

A forgotten diplomatic controversy centered on the claim to U.S. protection by a yet‐to‐be‐naturalized citizen is analyzed to offer insights into the mid‐nineteenth century understanding of the status and function of the documentation of individual identity. It makes clear the documentation of identity had a contested and gradual development. Documentation was contested in that people (both officials and members of the public) struggled to understand how it was that a document identified a person. This uncertainty centered not only on who had the authority to document identity, but how that authority was represented on a document. Beyond its mid‐nineteenth century and U.S. focus this essay is intended to provide the context for an understanding of the administrative, bureaucratic, and social developments that had to occur before identification documents could play a pivotal role in the development of the twentieth century state. In this way it suggests that official identification is an important object of analysis for debates about the articulation of information and governing in state formation.     

The legal rights of LGBT youth in state custody: what child welfare and juvenile justice professionals need to know

Youth in state custody, regardless of their sexual orientation or gender identity, have federal and state constitutional and statutory rights. These rights guarantee a young person safety in their placement as well as freedom from deprivation of their liberty interest. Many lesbian, gay, bisexual, and transgender (LGBT) youth have these rights violated on a regular basis. Many cases in both the child welfare and juvenile justice contexts have resulted in extensive and time-consuming consent decrees as well as sizable damages awards. Knowledge of a youth's legal rights can help providers avoid legal liability while creating a safer and healthier environment for LGBT youth. This article provides a general overview of the successful federal legal claims that youth in the child welfare and juvenile justice systems have made, discussion of the rights generated as a result, particle application of these rights to the experiences of LGBT youth with hypothetical scenarios, a focus on specific rights that emanate from certain state laws, and a focus on specific concerns of transgender youth.     

The Community Development for Healthy Children Initiative

Abstract

An increasing interest in positive youth development has led to the creation and expansion of programs and initiatives related to youth involvement and engagement. This article focuses on the Community Development for Healthy Children initiative, which envisions making Kansas the best state in the nation in which to raise a child. The initiative includes three primary strategies: A multi-media campaign; technical assistance and support to local communities; and mini-grant opportunities. The paper provides examples of activities from across the state that promote youth involvement. Outcomes across four areas are examined, and the benefits and challenges of this initiative are also discussed.     

Critical Experiential Pedagogy: Sociology and the Crisis in Higher Education

Higher education is in crisis, especially in the public sector. Over the past few years, tuition at state universities across the country has increased dramatically, their budgets have been slashed and federal funding for need-based financial aid has been reduced. The results are increased class sizes, fewer course offerings, more adjunct faculty and fewer working-class students at public colleges and universities. In Massachusetts, where we teach, these trends are particularly pronounced. In this paper, we describe “Crisis in Higher Education,” a critical experiential course we offered to raise student awareness about the crisis and to encourage them to work for change on our campus. This course is an example of critical experiential education because it integrates classroom learning with political activism. This article describes the context and rationale for teaching the course, reports on students’ responses to its form and content, and discusses what we learned from this experience.