Spatial Equity in the Allocation of Funds to State Secondary Schools

Disproportionate attention is often focused on government programs which are adopted as part of a political platform. Yet these are often marginal in terms of the expenditures involved. Such is the case with education. The disadvantaged schools program introduced by the Whitlam Labor government involved only a very small outlay compared with the annual expenditure on education in Victoria. This paper argues that it is important to find ways of evaluating the spatial and social impact of the main bulk of government programs. Evidence is adduced which casts some doubt on the equity with which state government funds for state secondary schools have been allocated spatially in metropolitan Melbourne.     

How Good a Deal Was the Tobacco Settlement?: Assessing Payments to Massachusetts

We estimate the increment in Massachusetts Medicaid program costs attributable to smoking from December 20, 1991 to 1998. We describe how our methods improve upon earlier estimates of analogous costs at the national level. Current costs to the Massachusetts Medicaid program approximate the payments to Massachusetts under the tobacco settlement of November 1998. Whether these payments are viewed as appropriate compensation for Medicaid costs over time depends upon the rate of increase in future health care costs, the rate of decline in smoking, the proportion of smoking that should be attributed to the actions of the tobacco companies and the likelihood the state would have prevailed at trial. The costs to the Medicaid program are dwarfed by the internal costs to smokers themselves.     

Evaluating the Impact of Statewide Anti-Tobacco Campaigns: The Massachusetts andCalifornia Tobacco Control Programs

Despite more than 30 years of public health programs to reduce tobacco use, smoking is still the leading preventable cause of death in the United States. In response to this continuing epidemic, voters in California (1988), Massachusetts (1992), Arizona (1994), and Oregon (1996) approved ballot initiatives that established statewide tobacco control programs funded by cigarette excise tax revenues. Evaluating these innovative public health interventions is important, both to improve existing programs and to guide other states in developing and implementing similar interventions. In this paper we describe the methods being used to evaluate the statewide anti-tobacco campaigns in California and Massachusetts, and review the findings of process and outcome evaluations of both programs.
Our review suggests that both programs have had a substantial impact on the public's health by reducing cigarette consumption and stimulating the development of policies to reduce environmental tobacco smoke exposure. However, it does not appear that either program has reduced smoking initiation among adolescents. Our evaluation suggests three problems in program implementation that future anti-tobacco campaigns must avoid in order to produce long-term, sustained effects: (1) the gradual erosion of program funding by the state legislatures and governors; (2) the lack of a consistent, supportive constituency within state government; and (3) inconsistency in campaign themes, messages, and programs. We conclude by offering recommendations to correct these problems so that statewide cigarette-tax-funded anti-tobacco campaigns can realize their potential to become one of the most effective public health interventions available.     

Equality of opportunity and treatment: Namibia. Working for equality

In 1991, the government of Namibia created a Department of Women's Affairs. The objectives of the Department are: a) to integrate women into all development programs; b) to coordinate women's programs; c) to establish links with international women's organizations; d) to establish a network among governmental and non-governmental organizations; and e) to advise the government and assist in the eradication of discriminatory laws.     

Task force on Medicaid in Missouri: a community collaboration in gerontological social work education

Master's level social work gerontology students formed a Task Force on Missouri Medicaid as the primary course project of the Social Policy and Aging class at George Warren Brown School of Social Work, Washington University in St. Louis. Led by students, the Task Force collaborated with community leaders to address issues with the escalating enrollment and cost of Missouri's Medicaid program, resulting in a widely disseminated policy brief. Students identified multiple professional skills gained through this assignment and community leaders determined the issue brief to be a significant contribution to Missouri's Medicaid policy debate.     

Welfare reform and elderly immigrants' health insurance coverage: the roles of federal and state medicaid eligibility rules

Immigrants' access to federally-funded Medicaid became limited after welfare reform imposed restrictive noncitizen eligibility rules. This study used a representative sample from the Current Population Survey (N?=?105,873) and state-level data to examine the effects of these policy changes on elderly immigrants. Triple difference-in-differences analyses show that federal restriction of eligibility had a significantly negative association with elderly immigrants' Medicaid coverage, and generous state eligibility had significantly positive relationships with Medicaid and any health insurance coverage. Findings indicate the important role of eligibility on elderly immigrants' health insurance coverage. Results call for social workers' actions to expand elderly immigrants' Medicaid eligibility.     

Enriching Resources for the Poor: Lessons from the Philippines

The paper provides an overview of the poverty situation in the Philippines, followed by a brief profile and assessment of two anti‐poverty programs: the Kapit‐Bisig Laban sa Kahirapan‐Comprehensive and Integrated Delivery of Social Services (KALAHI‐CIDSS) program and the Pantawid Pamilyang Pilipino Program (4Ps). Official statistics disclose that the global economic crisis in 2008 adversely affected Filipino households, leading to higher levels of poverty especially in rural areas. In response, government introduced an Economic Resiliency Program with social protection as one component. Sixty‐six social protection programs were launched, including the two under review. KALAHI‐CIDSS and the 4Ps apply poverty reduction strategies that focus on the development of human and social capital, rather than economic capital. They involve processes and relationships that aim to improve the other dimensions of poverty, such as lack of access to opportunities or deprivation of basic human necessities. Qualitative and quantitative reports describe generally favorable outcomes from both programs. However, these gains at the household level need to be supported by relevant policy, enhanced public services and badly‐needed infrastructure programs from government, in order to sustain achievements culled from social protection programs and attain broader developmental impacts.     

Chapter 17. Rural Mental Health

SUMMARY

Mental health services available in many rural communities are too limited in scope and availability to meet the needs of rural citizens. The future of mental health services for the rural poor will be impacted by state government decisions about Medicaid funding priorities. It is important that rural practitioners, especially those that work in the fields of mental health, health, and aging services, engage in advocacy for better coverage of the rural poor and low-income elderly persons. This chapter discusses issues of advocacy related to improving the provision of mental health services to older rural citizens as an important goal in the larger effort to expand and improve rural mental health service delivery throughout the nation.     

Canada's Social Security Review

Canada's social security system is a patchwork quilt of relatively discreet and uncoordinated programs built up over many decades. While constitutional responsibilities for income security and social services rests with the provinces, federal program initiatives were seen to be eroding the provincial responsibilities and causing confusion between federal and provincially financed programs. The Review of Social Security attempted to comprehensively evaluate the ‘system’ of programs in Canada to correct deficiencies. Financing and respective government responsibilities were also examined. The three year review did not result, in the author's opinion, in sufficient changes in the social security system ‘for the benefit of all Canadians’. The failure to adequately confront employment (unemployment) issues was one gap. Another was the failure to implement changes in income supplementation for the working poor. Tangible results included the introduction of a new Social Service Act which permits cost sharing, and increased cooperation between and among departmental officials and ministers. The Canadian experience contains lessons for the development of joint social policies between state and commonwealth governments in Australia.     

Financial self‐sufficiency or return to welfare? A longitudinal study of mothers among the working poor

Cheng T. Financial self‐sufficiency or return to welfare? A longitudinal study of mothers among the working poor Int J Soc Welfare 2010: 19: 162–172 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This study investigated how working‐poor mothers who withdrew from a US government assistance program were affected by the economy, welfare reform policies, and their own human capital, in terms of their likelihood of returning to welfare and their likelihood of becoming nonpoor through work. The study employed longitudinal data (covering 42 months) extracted from a national data set. The sample for the current study, which relied on event history analysis, consisted of 228 working‐poor former welfare mothers. Results showed that the women's return to welfare was correlated to high unemployment, restrictive welfare policies, enrollment in Medicaid and food‐stamp programs, possession of service‐job skills, and being Hispanic. The women were most likely to attain relative financial independence in the presence of generous government assistance program policies, housing assistance, full‐time employment, operative‐job skills, college education, and marriage. African American ethnicity also made achievement of financial independence more likely.     

Innovating in Digital Government in the American States

Objective. The purpose of this research is to examine why some states have embraced digital government more extensively than others. Methods. Multivariate regression analysis is used to empirically test explanations for state innovation in e–government. The primary dependent variable is the percent of state–level government websites offering online services to citizens. Results. Republican–controlled legislatures are more likely to embrace e–government, implying that efficiency concerns may drive reliance on digital government. Innovators in e–government were states with fewer households with Internet access and less use of the initiative process, indicating that citizen demand was not a factor. More extensive use of e–government is also associated with legislative professionalization and professional networks—factors that may be useful for explaining the diffusion of other administrative reforms, and technical issues lacking political salience.
Conclusions. These data suggest e–government implementation is driven by legislative professionalism and, to a lesser extent, state professional networks, rather than citizen demand. These indicators fit Lowi's (1972) conception of "constituent policy" as a top–down process, confined to administrative or legislative circles, compared to distributive, regulatory, and redistributive policy. We hypothesize that other administrative reforms, particularly those lacking political salience, may exhibit similar relationships with legislative professionalization and professional networks.     

The impact of ethnicity on attitudes toward health care reform in New Mexico

Latinos tend to have significantly lower levels of access to general and top quality medical care than do non-Latino whites, and although disparities in access to health care have diminished for all other minority groups over time, they have widened for Latinos. Given these trends, current attempts to provide universal health care at both the national and state levels across the United States have large implications for the health status of Latinos. The objective of this analysis is to determine whether Latinos have different attitudes regarding health reform than non-Latino whites. Our data are from a statewide random digit dialing telephone survey of New Mexico residents, age 18 and older, conducted in the Fall of 2007. With a Latino population of 44% and ongoing health care reform efforts by the state legislature, New Mexico is an ideal location for this analysis. After controlling for a host of individual level factors, our findings suggest that while Latinos are less likely to identify health care as a salient state issue relative to the economy and crime, they are more likely than non-Latino whites to believe affordable health care programs are important. Finally, Latinos view employers, more than government or individuals, to be responsible for expanding health care coverage.     

Welfare Reform and Elderly Immigrants' Health Insurance Coverage: The Roles of Federal and State Medicaid Eligibility Rules

Immigrants' access to federally-funded Medicaid became limited after welfare reform imposed restrictive noncitizen eligibility rules. This study used a representative sample from the Current Population Survey (N?=?105,873) and state-level data to examine the effects of these policy changes on elderly immigrants. Triple difference-in-differences analyses show that federal restriction of eligibility had a significantly negative association with elderly immigrants' Medicaid coverage, and generous state eligibility had significantly positive relationships with Medicaid and any health insurance coverage. Findings indicate the important role of eligibility on elderly immigrants' health insurance coverage. Results call for social workers' actions to expand elderly immigrants' Medicaid eligibility.     

Welfare Generosity,Abortion Access,and Abortion Rates: A Comparison of State Policy Tools*

Objective. This article tests if welfare generosity is related to abortion rates, allowing effects to vary by program type and abortion policy context. Methods. Measuring welfare generosity with respect to cash assistance, family caps, Medicaid, child care and family leave policies, I estimate fixed effects models of abortion rates in 48 U.S. states over 1987–2000. Results. More expansive family leave laws are associated with lower abortion rates. In states that do not enforce any of three key abortion policies, increased Medicaid eligibility and child care spending predict higher abortion rates. For Medicaid, this relationship diminishes and reverses itself as states add abortion regulations. Conclusion. Welfare state expansions may help reduce abortion, but programs' effects are not unambiguously pro‐natalist. Estimated impacts of welfare generosity on abortion rates vary by program, and some with abortion policy context.     

Hospice use by older adults knocking on the door of the nursing facility: implications for social work practice

Since 1983, federal funding has been available for hospice services. However, research studies have found that hospice is underutilized by people with terminal illnesses and their families. Low-income older adults are particularly at risk for underutilization. This study examined utilization of hospice services by nursing home applicants in one Midwestern state. Characteristics of users and non-users, and potential barriers to hospice use were examined. Findings further document that hospice is underutilized, especially by the Medicaid population, and point to barriers to hospice utilization. Specific recommendations are made to help practitioners increase hospice access.     

The Poverty Situation in Indonesia: Challenges and Progress of the Marginalized Group

This paper focuses on Indonesian poverty alleviation programs. It examines the national poverty reduction programs of cash‐based support projects for the poorest of the poor and highly marginalized groups. Indonesia was the country hardest hit by the East Asian financial crisis of the late 1990s. In 2005, Indonesia began unconditional cash transfers (UCT) for the first time – giving cash money to the poorest, poor and near‐poor targeted households. As a result, the income of the poorest households receiving UCT increased by 1.3 times compared to that of non‐recipients. The UCT can be seen as a new benchmark for Indonesia as a mechanism of a “shockbreaker” for the poor affected by the crisis. In 2007, the government of Indonesia began a trial of the conditional cash transfer (CCT) program known as the Hopeful Family Program (Program Keluarga Harapan or PKH). The CCT program was provided to poor families with an allowance conditional on their attention to their children’s education and health. With this program, women in the community gained access to new resources, in the form of the additional cash. CCT is planned to be the basis of the development of a future social security system.     

Hospice Use by Older Adults Knocking on the Door of the Nursing Facility

Abstract

Since 1983, federal funding has been available for hospice services. However, research studies have found that hospice is underutilized by people with terminal illnesses and their families. Low-income older adults are particularly at risk for underutilization. This study examined utilization of hospice services by nursing home applicants in one Midwestern state. Characteristics of users and non-users, and potential barriers to hospice use were examined. Findings further document that hospice is underutilized, especially by the Medicaid population, and point to barriers to hospice utilization. Specific recommendations are made to help practitioners increase hospice access.     

The government spending multiplier: Evidence from county level data

The passage of the American Recovery and Reinvestment Act (ARRA) of 2009 has brought fiscal policy to the forefront once again. The size of the “multiplier” of government spending becomes of critical importance for determining the effect of stimulus programs. Yet there is considerable controversy about this issue. This study adds to the discussion on the size of the multiplier by using earnings data by county. This allows the creation of a panel data that includes 3141 counties for the time period 2001–2012. We estimate the federal government spending multiplier to be approximate 1.5. Our estimate for state and local spending multipliers are considerably smaller. Our results have implication for policy in that federal programs will be more effective for stabilization county economies than state or local spending.     

Immigrant households and hardships after welfare reform: a case study of the Miami-Dade Haitian community

Compared with other nations such as Canada and Australia, the US experiment with welfare reform has yielded steeper and more immediate caseload declines. These declines have been especially pronounced for immigrants who have been subject to a new set of service restrictions implemented under the 1996 Welfare Reform Act. This article examines service access for Haitian immigrants in Miami, Florida since the onset of these reforms. The data presented here are derived from a series of qualitative interviews with Haitian service professionals and a quantitative survey of Haitian immigrant households. The survey data indicate that many Haitians who are living in poverty and qualified to access services are not enrolled for government services. Confusion over eligibility guidelines explains some of the variation of these low enrolments for specific services (such as child health insurance and childcare) but not for services most commonly used by immigrant adults such as food stamps and Medicaid. The survey also demonstrates that qualified immigrants living in households with unqualified persons are less likely to access services than are other qualified immigrants and are more likely to experience hardships that impede their ability to find stable employment. The concluding discussion highlights the significance of using a household unit of measure in assessing immigrant enrolments and hardships.     

Seven years of evaluating income management ‐ what have we learnt? Placing the findings of the New Income Management in the Northern Territory evaluation in context

Income management programs ‐ which restrict how some recipients of government transfers can spend these funds ‐ have operated in Australia since 2007. The nature of the programs implemented varies, especially in regard to the combination of voluntary and compulsory elements, and there are also differences in scope and targeting. A number of evaluations and other studies of these programs have been undertaken. These vary in rigour, methodology, and the set of programs considered. This has led to an apparent diversity of findings, which has been exaggerated by selective use in public debate. The largest and most in depth evaluation has been that of ‘New Income Management’ in the Northern Territory. This found that the program had not achieved its objectives and appears to have created dependence. The relative outcomes of the studies are considered.