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.     

Serial Joy and Serial Sorrow: The Experience of the Paraprofessional Serials Manager

Abstract

Paraprofessionals play a major role in the management of serials operations in libraries. Nine paraprofessional serials managers responded to an inquiry on the SERIALST online discussion list in which they shared their impressions on several issues relating to their role, status, motivation, and general perceptions about their work. For many years, there has been an ongoing debate relating to the role of paraprofessionals in libraries. Many library paraprofessionals have advanced their careers in the field of serials and have become managers of high-level operations. This Balance Point column explores the experiences of some of these paraprofessional serials managers.     

Job continuity among new mothers

In the early 1990s, both state and federal governments enacted maternity-leave legislation. The key provision of that legislation is that after a leave of a limited duration, the recent mother is guaranteed the right to return to her preleave employer at the same or equivalent position. Using data from the National Longitudinal Survey of Youth, we correlate work status after childbirth with work status before pregnancy to estimate the prevalence, before the legislation, of returns to the preleave employer. Among women working full-time before the pregnancy, return to the prepregnancy employer was quite common. Sixty percent of women who worked full-time before the birth of a child continued to work for the same employer after the child was born. Furthermore, the labor market behavior of most of the remaining 40% suggests that maternity-leave legislation is unlikely to have a major effect on job continuity. Compared with all demographically similar women, however, new mothers have an excess probability of leaving their jobs.     

Child care for preschoolers: Differences by child’s age

Because of the high rates of employment of mothers, a large and increasing number of preschool children receive regular care from someone else. This article develops and tests hypotheses about the choice of child care arrangements for younger and older preschool children, using data from the National Longitudinal Survey of Young Women. We argue that appropriate care depends on the age of the child. It includes care by the mother or a paid provider in the child's home for children aged 0-2 and mother care and nursery school or center care for those 3-5. We estimate models of the mother's employment and choice of child care separately for younger and older preschoolers. Our results show that need for care, presence of substitutes for the mother, financial resources, and preferences all affect both full-time care by the mother and the type of child care chosen by working women, although they affect these two decisions in different ways.     

Differences between sexually victimized and nonsexually victimized male adolescent sexual abusers: developmental antecedents and behavioral comparisons

This study compares sexually victimized and nonsexually victimized male adolescent sexual abusers on a number of variables. Self-report measures were administered to 325 male sexually abusive youth (average age 16) in six residential facilities in the Midwest, 55% of whom reported sexual victimization. The results indicate that the sexually victimized sexual abusers have more severe developmental antecedents (trauma, family characteristics, early exposure to pornography and personality) and recent behavioral difficulties (characteristics of sexual aggression, sexual arousal, use of pornography, and nonsexual criminal behavior) than the nonsexually victimized group. Results are contrasted with recent typological research, which found no relationship between sexual victimization and subtype membership. Treatment, research, and theoretical implications are discussed.     

MOOCs and Serials

Massive Open Online Courses (MOOCs) are becoming increasingly common (and controversial) as platforms for course delivery. Paul Bond shares his insights on MOOCs from the perspectives of class participant and librarian.     

FAMILY BEQUESTS AND THE DERIVED DEMAND FOR HEALTH INPUTS

A family investment model whereby parents allocate resources among their own consumption, health investments and financial bequests to children is specified and used to develop hypotheses which are tested on cross section data. As predicted by the model, the demand for physician visits for young children is found to 1) depend on family income only up to some level ($10,000 in 1969 $ in this case), 2) increase with maternal education, and 3) vary with price measures and family size, There is also evidence that greater health investments in young children pay off in fewer severe illnesses in young adulthood.     

The Future of Ethnic Newspapers in the United States and Canada

Abstract

In interviews with the editor, James Danky reflects on the role and future of the ethnic press in the United States, and Thomas Saras comments on the importance and future of the ethnic press in contemporary Canadian society.     

School,Social-Communicative,and Academic Challenges Among Delinquents and Juvenile Sexual Offenders

This study explores the association between student factors and delinquency by comparing two groups of adjudicated youth in six Midwestern residential facilities: 331 young men committed for a sexual offense, and 171 committed for a nonsexual offense. Statistically significant findings include juvenile sexual offenders exhibiting a greater number of delinquent behaviors and greater academic and social difficulties compared with their counterparts adjudicated for a nonsexual offense. Additionally, path analysis revealed that school experience was negatively associated with delinquency for both groups. For juvenile sexual offenders, academic difficulties were associated with delinquency through their school experience. Among general delinquents, delinquency was directly associated with social difficulties and school experience. Implications for interventions and future research are discussed.