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.     

Individualised Support and Funding: building blocks for capacity building and inclusion

The paradigm in disability supports is shifting away from institutional services and professional control towards self-determination and community involvement of people with disabilities. The assumption that the best way to provide disability supports is for government to give money to agencies or services, rather than directly to people with disabilities and their support networks, is being challenged. This article reports on findings and themes from a Canadian study that investigated individualised funding projects from different parts of the world. Ten of fifteen of the most 'promising initiatives' were selected for more detailed study and analysis. Projects analysed were from Canada, the US, and Australia. Themes emerging from the study included the fact that values and principles mattered, a policy framework provided coherence and equity, infrastructure supports for individuals were separate from service system, the facilitator-broker role differed from case management, allocation of individualised funds was designed to be equitable and account able to the funder and person, and a 'learn as you go' philosophy maximised positive outcomes. This research project demonstrates that individualised support and funding, when embedded in the new paradigm of disability and community, builds capacity of individuals, families, and communities.     

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.     

Transnational Migration: Bringing Gender In

This article aims to bring gender into an even tighter transnational migration focus by broadening and deepening our original framework of “gendered geographies of power,” linking it more directly to existing and emerging scholarship. We examine and highlight previously neglected areas such as the role of the state and the social imaginary in gendering transnational processes and experiences. We identify topics that remain under‐appreciated, under‐researched, and/or under‐theorized. Finally, we initiate a discussion of how a gendered analysis of transnational migration can help bridge this particular research to other gendered transnational processes under study that do not privilege migration.     

Foster parenting: A developmental model

This paper proposes a developmental framework for foster parents and outlines four distinct growth stages. Such a framework can be of value to program administrators who are required to assess foster parent development during the crucial matching process. To draw a distinction between each developmental stage, specific instrumental tasks and indicators are outlined.