Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.     

Banks winners in tournaments are difficult to recognize

Given a tournament T, a Banks winner of T is the top vertex of any maximal (with respect to inclusion) transitive subtournament of T. In this technical note, we show that the problem of deciding whether some fixed vertex v is a Banks winner for T is NP-complete. Received: 22 February 2002/Accepted: 20 June 2002 Supported by the START program Y43-MAT of the Austrian Ministry of Science. I would like to thank two thank the referees for a careful reading of the paper, for helpful remarks, and for many suggestions how to improve the presentation.     

Family Cap and Nonmarital Fertility: The Racial Conditioning of Policy Effects

Using an experimental design, this research examines the effect of the nation's first family cap on the births, abortions, and contraception use of over 8,000 women receiving public assistance in New Jersey. The family cap denies additional cash benefits to children conceived while the mother is receiving public assistance. Our research shows that a targeted welfare benefit manipulation does influence fertility behavior; however, the effect is conditioned by race. We find that Black women in the experimental group have a 21% lower birth rate and a 32% higher abortion rate than Black women in the control group. We do not find a birth effect for Hispanic or White women. We discuss the policy implications of the effects of a segmented family cap.     

Boundary Spaces

While shows like The X-Files and 24 have merged conspiracy theories with popular science (fictions), some video games have been pushing the narrative even further. Electronic Art's Majestic game was released in July 2001 and quickly generated media buzz with its unusual multi-modal gameplay. Mixing phone calls, faxes, instant messaging, real and "fake' websites, and email, the game provides a fascinating case of an attempt at new directions for gaming communities. Through story, mode of playing, and use of technology, Majestic highlights the uncertain status of knowledge, community and self in a digital age; at the same time, it allows examination of alternative ways of understanding games' role and purpose in the larger culture. Drawing on intricate storylines involving government conspiracies, techno-bio warfare, murder and global terror, players were asked to solve mysteries in the hopes of preventing a devastating future of domination. Because the game drew in both actual and Majestic-owned/-designed websites, it constantly pushed those playing the game right to borders where simulation collides with " factuality'. Given the wide variety of "legitimate' conspiracy theory, alien encounters and alternative science web pages, users often could not distinguish when they were leaving the game's pages and venturing into " real' World Wide Web sites. Its further use of AOL's instant messenger system, in which gamers spoke not only to bots but to other players, pushed users to evaluate constantly both the status of those they were talking to and the information being provided. Additionally, the game required players to occupy unfamiliar subject positions, ones where agency was attenuated, and which subsequently generated a multi-layered sense of unease among players. This mix of authentic and staged information in conjunction with technologically mediated roles highlights what are often seen as phenomenon endemic to the Internet itself; that is, the destabilization of categories of knowing, relating, and being.