icy/cost
———, “How Much Does Business Interruption Insurance Cost?” webpage, undated-b. As of April 5, 2021:
https://www.insureon.com/small-business-insurance/business-interruption/cost
Internal Revenue Service, Statistics of Income—2017: Corporation


Annual Payroll, and Preliminary Receipts by Enterprise Employment Size for the United States, All Industries: 2017,” Excel file, March 6, 2020. As of May 5, 2021:
https://w w w.census.gov/data/tables/2017/econ/susb/2017-susb-annual.html
U.S. House of


onsequences. Proposed programs are evaluated in terms of the proportion of revenue decline replaced (efficacy), efficiency, affordability, the risk borne by the commercial insurers, expected annual government net outlays, and the amount of subsidy pr


  CORPORATION
SHAWN D. BUSHWAY, DULANI WOODS, DENIS AGNIEL, DAVID M. ADAMSON
Small Businesses, Criminal Histories, and the Paycheck Protection Program
There is a growing realization of the potential importance of business ownership for people with cr


d of fraud, bribery, embezzlement, or a false statement in a loan application or an application for federal financial assistance. For all other felonies, the restrictions were limited to a one-year window after conviction for those not incarcerated (


ers estimated that as many as 2.6 to 3.2 percent of sole proprietors were ineligible for PPP loans based on one of the five
 Abbreviations
CI confidence interval
CJARS Criminal Justice Administrative
Records System
PPP Paycheck Protection Program
SBA


identification for different areas is known as entity resolution. An entity resolution algorithm helps link possibly ambiguous characteristics (such as criminal history records) to an object or individual (Talley, 2011). As an example of linking bus


- tion of small business owners with a criminal history. We have no direct information on how often this occurred, but the broad agreement of our prevalence estimates with Finlay, Mueller-Smith, and Street’s (2020) estimates and with our state-level


g recent felonies.
First, we used the probability of felony status being unknown given everything we already know about the individual and business. For example, if most of the records in North Carolina have unknown felony status, a greater burden wo


, our estimate of affected employees could reasonably be considered a lower bound.
Estimated National Prevalence of Small Business Owners with a Felony Conviction
We first estimate the number of small business owners who had at least one felony convi


ffected Businesses Under the Original and Revised Paycheck Protection Plan Restrictions
We estimate that under the revised 2021 PPP restrictions, the number of businesses affected dropped by 95 percent—from 212,655 (0.47 percent of small businesses)


f businesses
120,000
NOTE: Employee estimates were conservative: When an owner was known to be affiliated with multiple businesses, only one business was used to contribute to the employee estimate. In addition, employee estimates were on the lower e


paragraph also could be caused by variation in criminal justice policies. For example, the same crime could be a misdemeanor in one state but a felony in another. This is particularly pertinent to our research because of the current progress of mari


Public administration
Educational services
Information
Arts, entertainment, and recreation
Finance and insurance
Real estate and rental and leasing
Agriculture, forestry, fishing, and hunting
Health care and social assistance
Wholesale trade
Transpor


findings would likely change but could be less accurate, as
the PPP restrictions apply only to individuals with a 20-percent or larger ownership stake.
Using this final sample frame, we asked DatabaseUSA to randomly sample its records by state and bu


nnesota’s real-world equivalent; as a result, our estimate for any criminal activity for Minnesota should be viewed as a minimum estimate.
Second, name-based matching approaches will inevitably produce false positives (individuals incor- rectly match


tage)
2.0
1.0
0
All criminal history
      3.43
 2.48
2.54
   0.82
0.86
   0.38
 0.22
 0.09
0.13
 3.0
        All Within felonies 5 years
All criminal All
Within 5 years
All criminal history
All felonies
Other
Within 5 years
Construction
NOTE: Data w


m seven states; second, the researchers only considered sole propri- etorships. Individuals involved in partnerships or other small businesses were not included. As a result, this study did not provide a national picture of how many small business ow


of a felony; 8 per- cent of the general adult population have ever been convicted of a felony (Shannon et al., 2017). The SBA has a long record of imposing restrictions on loans and other aid to small businesses owned by individu- als with criminal


ed criminal history data have been used by researchers to generate national estimates of the prevalence of criminal history records in the United States. In this report, we have compared our results from this new approach with results from other, mor


record restrictions. Consumer and background check data could be used to identify businesses that have an owner or owners with criminal history records and that also received PPP loans. However, because consumer and back- ground check companies expec


were ignored. Nonetheless, written restrictions could have discouraged applicants who did not want to run afoul of federal rules (Brayne, 2014).
2 For example, when working directly with state criminal history data, we checked for duplicate name and


2, 2021. As of May 21, 2021: https://www.arnoldventures.org/newsroom/a-statement- from-arnold-ventures-on-the-biden-harris-administrations- expansion-of-the-paycheck-protection-program
Bang, Heejung, and James M. Robins, “Doubly Robust Estimation in


,” webpage, undated-a. As of May 18, 2021: https://chs.state.mn.us/Home/Faq
———, “Search Public Criminal History,” webpage, undated-b. As of May 18, 2021:
https://chs.state.mn.us/Search/ChsSearch
North American Industry Classification System Associat


- increases-lending-to-small-businesses-in-need-announces- changes-to-ppp-to-further-promote-equitable-access-to-relief
 18
Acknowledgments
The authors would like to thank Tim Pinkerton of DatabaseUSA for his patience through hundreds of iterations a


ted in the Justice Policy Program within RAND Social and Economic Well-Being. The program focuses on such topics as access to justice, policing, corrections, drug policy, and court system reform, as well as other policy con- cerns pertaining to publi


  CORPORATION
DEBORAH R. HENSLER, JASMINKA KALAJDZIC, PETER CASHMAN, MANUEL A. GÓMEZ, AXEL HALFMEIER, IANIKA TZANKOVA
The Globalization of Mass Civil Litigation Lessons from the Volkswagen “Clean Diesel” Case
   For more information on this publicat


more intriguing examples of this type of litigation, the recent Volkswagen (VW) “clean diesel” case, a global litigation that proceeded in parallel in multiple national jurisdictions. Many scholars and practitioners believe that this sort of transna


s, all those who participated in the roundtable, and our colleagues who have contrib- uted over the years to our knowledge about global mass civil litigation. We would also like to thank the peer viewers, Michelle Grisé and Roger Trangsrud, for thei


ing the story of the lawsuits against VW forward beyond the date of the roundtable, we are able to suggest some of the consequences of procedural variation.
The roundtable discussion suggested that the VW litigation is not a “one-off.” Indeed, many p


 services are manu- factured and sold worldwide, problems associated with these products and services inevita-
1 In the popular press and many legal documents, this software was referred to as a defeat device.
2 See, e.g., Margaret Moses, The Princip


to the phenomenon of global litigation while at the same time preserving their own legal culture and autonomy? What peculiar legal problems are created by parallel proceedings in different jurisdictions, and what are the possible solutions? Is there


ere pleased with the enthusiasm for discussion that the participants exhibited during the day. We learned a lot about jurisdictional differences and similarities in response to mass civil litigation and attitudinal differences about the causes and co


ns from 2007 to 2011,2 was a natural venue for the roundtable. RAND’s long history of studying mass tort litigation, class actions, and mass compensation systems made it a natural partner in this initiative. Ultimately, the RAND Institute for Civil J


the procedural rules and practices for addressing them vary from jurisdiction to jurisdiction. The legal position is further complicated by the fact that choice of law rules also vary from jurisdiction to jurisdiction. When there are large numbers of


of the same facts and law. The modern form of the U.S. class action is spelled out in federal Rule 23 and its state counterparts.3 Briefly, when there are numerous claims that share common features, a judge may certify the litigation to proceed as a


ertifica- tion and settlement approval.6 The provision for class members to object to proposed settle- ments is said to have given rise to the development of professional objectors, represented by counsel who allegedly attempt to leverage the potenti


Class Actions, 2005–2012,” Fordham Law Conference, Vol. 87, No. 1, February 2018.
8 Code of Civil Procedure, RSQ c C-25.01, Book VI, art. 571–604.
 9
The Globalization of Mass Civil Litigation: Lessons from the Volkswagen “Clean Diesel” Case
 however


5 of Ontario Regulation 771/92 to consider applications to the fund and make a determination whether to fund a class action on the basis of three primary considerations: the extent to which the issues in the proceeding affect the public interest, th


be permitted to proceed as a class action, including on the basis that the class requirements are not satisfied. Other statutory provisions permit the court to consider whether the case can proceed as a class. Such challenges, although not common, d


r any adverse costs order or requirement to provide security for costs,17 whereas the class members are not liable for adverse costs or security for costs.18 This allocation of costs and risks, which enables all other class members to “free ride” on


ith judges to seek to achieve equity in such circumstances. One innovation was to make funding equalization orders, whereby the same percentage amount payable by funded class members to the funder was deducted from the amount payable to nonfunded cla


cision is Lenthall v Westpac Life Insurance Services Ltd [2019] FCAFC 34. The High Court decisions are BMW Australia Ltd v Brewster and Westpac Banking Corporation v. Lenthall [2019] HCA 45 (December 4, 2019).
21 Haselhurst v Toyota Motor Corporation


Australian Law Reform Commission, Integrity, Fairness and Efficiency—an Inquiry into Class Action Proceedings and Third-Party Litigation Funders, Brisbane, 2018. The Australian Law Reform Commission made 24 recom- mendations for reform of class acti


pMuG procedure is lim- ited to the field of prospectus liability and other claims based on alleged violations of capital market information duties.
In 2018, partly in response to the VW litigation, the Musterfeststellungsklage was created for consume


ge actions but rather lawsuits seeking declaratory or injunctive relief only. There is no certification requirement, and the lead plaintiff can be an established foundation or an association (such as the Dutch Shareholders’ Association), or it can be


when appointing the exclusive representative, the court will need to take a list of requirements into account with respect to the governance, representativeness, and financial status of the nonprofit entity to assess whether the interests of the grou


two decades, and Brazil has been generally regarded to be at the forefront, especially in the realm of consumer protection.38 The current legal framework rests on two important statutes and a constitutional provision—enacted between 1985 and 1990—tha


ng diffuse, collective, and individual-homogeneous rights.45 Diffuse rights usually refer to the preservation of a public good, such as envi- ronmental protection, as opposed to a private individual or a group interest.46 Collective rights are also t


ion: Lessons from the Volkswagen “Clean Diesel” Case
 the collective proceedings prove unsuccessful.52 The CDC contains some key pro-plaintiff features, such as the shifting of the burden of proof to the defendant, a strict liability rule that reliev


ers with little or no long-term commitment to the protection of consumer rights, but rather driven by the prospect of an early settlement that brings a large fee award.”63
The CPA vests Chilean judges with certain powers not commonly seen in ordinary


ve, procedures for aggregating claims and for representative collective actions vary significantly across jurisdictions. Depending on certain key features, a proce- dure will be more or less likely to be used by claimants. Most obviously, transsubsta


oved
association
Existing
Yes
Representative
Transsubstantive
association
and ad hoc
foundation
  Court Order? Certification or
Yes (court
Aggregate
(model
selects
  Aggregate or Representative
Scope Transsubstantive Transsubstantive
Jurisdiction
Rep


 litigation through about June 2020, as reported in this chapter.
1 The coauthors gratefully acknowledge the information provided by lawyers representing plaintiffs and defendants about the status of VW civil and criminal proceedings in their jurisdi


the automobiles’ emissions were many times greater than per- mitted under California’s tough pollution-control standards.
In March 2014, the research team presented its findings at a conference in Southern California. In the audience were automobile


RB issu- ing notices of violation to VW for the use of defeat devices in hundreds of thousands of VW diesel engine vehicles, environmental and consumer fraud attorneys from the offices of dozens of state attorneys general were participating in large


widely respected judge, in the Northern District of California. In its transfer order, the JPML noted that the litigation had connections to many parts of the United States. “We select Judge Charles R. Breyer as the transferee judge,” the panel wrote


rder, MDL 2672, December 8, 2015, p. 3.
13 David Shephardson, “Bosch Concealed Volkswagen Use of ‘Defeat Device’ Software: Lawyers,” Reuters, September 8, 2016.
14 Judge Breyer, Cabraser, Giuffra, and Feinberg all participated in the Stanford-RAND ro


a- tives of the DOJ, federal EPA, and CARB, as well as plaintiff and defense counsel, he asked: “What remedies are being proposed by Volkswagen to address the immediate problem of hundreds of thousands of vehicles on the streets and highways of the U


lty claims, nor federal criminal claims against Volkswagen, Audi, and Porsche. During the summer of 2016, settlement negotia- tions between the multistate Executive Committee and VW began to break down. Shortly thereafter, a significant number of sta


yer approved the first VW consumer class action set- tlement on October 25, 2016, about ten months after the JPML transferred the VW litigation to him.22 On the same date, Judge Breyer approved a consent decree ending parallel litigation brought by t


.26 The provisions of the later settlement with owners of 3.0-liter cars were somewhat more compli- cated, but it also offered owners a choice of a buyback or a vehicle modification and commit- ted VW to pay an additional $225 million into the enviro


iller, “Attorney Fees in Class Action Settlements: An Empirical Study,” Journal of Empirical Legal Studies, Vol. 1, March 2004; Theodore Eisenberg and Geoffrey P. Miller, “Attorney Fees and Expenses in Class Action Settlements: 1993–2008,” Journal of


.G. Schneiderman Announces Volkswagen to Pay New York $32.5 Million—Marking First-Ever NY State Environmental Enforcement Penalty Against an Automaker for Emissions Violations,” press release, March 30, 2017.
33 In re Volkswagen “Clean Diesel” Litiga


ison v. Australia National Bank,42 holding that the Securities and Exchange Act does not provide extraterritorial jurisdiction to federal courts.43 As a result, the locus of securities litigation arising out of the “clean diesel” scandal is Germany,


adian and U.S. VW and Audi subsidiaries. The plaintiffs sought general and puni- tive damages of more than C$4 billion or, alternatively, rescission of the purchase price of the vehicles. The allegations were founded in negligence (in the design of i


intiffs’ motion for certifi- cation for settlement purposes was granted in its entirety.51 The judge certified a class of “all persons” (excluding residents of Quebec, who were members of a separate class action in that province) who were registered


ounsel C$9.9 million.
In August 2017, the parties, including representatives of the U.S. and German defendants and of the Canadian Competition Bureau, entered into formal settlement negotiations in respect of the 3.0-liter diesel vehicles. The retire


orted lag issue to make an informed decision about their rights under the settlement. The motion judge found that the remedies for any lag issue were not available under—nor precluded by—the settlement agreement.
Two proposed securities class actions


ainst VW and other entities, which, after almost five years of litigation, were settled in the fall of 2019. Settlement approval hearings were held in early 2020. The regulatory proceedings were the subject of a penalty hearing in the Federal Court o


ave been centralized. If a class is certified, those counsel become class counsel. Neither Canada nor Australia has a statutory procedure akin to an MDL. When multiple lawsuits arising out of the same matter are filed, attorneys for the different pla


prepared and submitted expert evidence. Thus, the first-stage trial proceeded without the respondents calling any witnesses. The judgment on the separate questions was yet to be handed down when the settlement agreement was reached. This judgment wo


regulatory proceedings seeking civil penalties were commenced by the ACCC in 2016 and 2017. In the regulatory proceedings, the ACCC relied on causes of action in respect to conduct alleged to be misleading or deceptive or likely to mislead or deceive


n class action litigation are an obvious problem in such jurisdictions as Australia, where the representative applicants may be liable to pay the respondents’ costs if the litigation is unsuccessful.
Notwithstanding the inordinate delay and substanti


, which is the holding company of the VW group. These actions are of a lower monetary volume but still approach €1 billion altogether. Many of them have been brought before the lower court in Stuttgart, where Porsche’s headquarters are located. The l


alers. Most of these cases are financed through legal expenses insurance, which is widely available in Germany. The insurers first denied cover for such actions but were later forced by court decisions to provide it as the wave of litigation grew and


class action firm; myRight claims to represent about 40,000 individual claims that have been transferred to it in exchange for a 35 percent share in the expected proceeds. VW has attacked this financing scheme as illegal, but as of June 2020, only on


sgerichtshof, 25 May 2020, VI ZR 252/19.
83 “Braunschweig ist Spitzenreiter bei VW-Klagen,” NDR, July 6, 2018.
84 Volker, 2019.
 45
The Globalization of Mass Civil Litigation: Lessons from the Volkswagen “Clean Diesel” Case
 the VW group consists of


dely agreed that all claims against VW were now time-barred, so that VW could be rather sure that no new claims would be brought if it started to admit wrongful behavior. On the other hand, VW wanted to finalize the settlement before May 5, 2020, the


W and the VZBV agreed that only 260,000 would be eligible for payment. In particular, the agreement excluded consumers who resided outside Germany at the time they purchased their cars. The agreement also excluded those consumers who had bought the c


l settlement, without pursuing litigation, were unsuccessful; in June 2020, the foundation decided to dissolve. The chair of the foundation, a former high- profile Dutch judge, was quoted as explaining that the foundation was unable to achieve its go


to be taken into account. In an interim ruling of November 20, 2019, the Amsterdam District Court rejected the majority of the motions. It decided that the collective action should proceed with respect to the majority of the claims of the private an


d a preliminary ruling interpreting Article 7(2) of Regulation (EU) No 1215/2012 of the European Union to provide jurisdiction for courts in the European Union to hear claims against VW from car buyers outside Germany. The advocate general for the EC


sumer protection advocates to jump on the bandwagon to hold the carmaker liable. Similar to what occurred with affiliates of the VW conglomerate in other jurisdictions, Volkswagen do Brasil Ltda (VW Brazil) faced actions on at least two fronts. The f


f São Paulo) surpasses R$65 million (approximately US$12 million to June 2020).98 The first and largest one, for R$50 million
96 Diário Oficial, Poder Executivo—Seção I, São Paulo: Imprensa Oficial, Vol. 129, No. 84, 2019, pp. 37–38. 97 Giorgio


d information about all the possible defects affecting the vehicles sold by VW Brazil. VW Brazil filed an appeal, which was subsequently denied. The case is yet to become final, as the losing
99 Brazilian Institute of the Environment and Renewable Na


ting from any illegal emissions caused by foreign vehicles manufactured by Porsche, VW, Audi, and Skoda and imported into Chile between 2006 and 2016.105 ODECU is a well-established consumer association created in 1994,106 and it is registered to fil


oda Fabia, emitted 6.6 times more NOx than the legal limit in Chile, and its pollution level was 9.2 times higher than the vehicle’s own certification. Regarding the United States, the complaint specifically mentioned the criminal action filed agains


tec, it argued that it was wrongfully included in the complaint because it had no relationship with VW and that
Ditec’s vehicles were different from those affected.
In September 2019, the parties requested that the court suspend the proceedings so th


 US$18,000 value per consumer in buybacks and direct payments; a total of US$9.5 billion value to approximately 537,000 consumers
Owners/lessees entitled to C$5,000–$8,000, plus choice to
sell or trade in the vehicle, terminate the lease without pena


inal indictments were also imposed. In other jurisdictions, compen- satory payments were modest, and resolution instead focused on remediation. Remarkably, however, although environmental regulations vary among jurisdictions and substantive and proce


 set of facts, claimants, and potentially liable defendants—that brought the roundtable participants together and engendered the lively discussion that took place in April 2019.
Lesson 2: On the surface, the VW litigation suggests that procedures for


er- ing to domestic law and proceedings.) It seems likely that cross-jurisdiction communication and informal coordination among lawyers and parties, if not, perhaps, judges, will lead to increasing similarity among procedural rules and possibly even


f Mass Civil Litigation: Lessons from the Volkswagen “Clean Diesel” Case
 Rules regarding the production and admissibility of evidence (especially documents) differ dramatically (with the U.S. discovery as the example of ease of obtaining documents a


on that U.S. consumers received for violations of strict U.S. regulations, which received extensive coverage internationally. This effect was amplified by the fact that the U.S. class
62
Lessons from the Volkswagen “Clean Diesel” Litigation
 action m


g representative actions on behalf of consumer interests, which was deemed not to “sufficiently address the challenges relating to the enforcement of consumer law.” See para. 9.
 63
The Globalization of Mass Civil Litigation: Lessons from the Volkswa


at this would reduce expense and delay in global litigation. To for- eign defense counsel, opening up their court proceedings to “U.S.-style discovery” was anath- ema. And some were wary of sharing even more-general information among judges, as it
64


ternational Court of Civil Justice, Cambridge, UK: Cambridge University Press, 2018.
 65
The Globalization of Mass Civil Litigation: Lessons from the Volkswagen “Clean Diesel” Case
 Lesson 9: In the long run, global mass civil litigation is more like


al University USA
Jutta Gurkmann Verbraucherzentrale Bundesverband Germany
 67
The Globalization of Mass Civil Litigation: Lessons from the Volkswagen “Clean Diesel” Case
 Axel Halfmeier Leuphana University Germany
Deborah Hensler Stanford Law School


overnment, Federal Register of Information, Vehicle Standard (Australian Design Rule 79/04—Emission Control for Light Vehicles), 2011, Sec. 2, Applicability and Implementation. As of October 5, 2020: https://www.legislation.gov.au/Details/F2012C00284


October 5, 2020: https://www.cand.uscourts.gov/judges/breyer-charles-r-crb/in-re-volkswagen-clean-diesel-mdl/ final-2-0-l-settlement/
Breyer, Charles R., “Executive Summary of Final Class Settlement Program (3.0 Liter Engine Vehicles),” U.S. District


 2020:
https://www.huntonak.com/en/covid-19-tracker.html
Diário Oficial, Poder Executivo—Seção I, São Paulo: Imprensa Oficial, Vol. 129, No. 84, 2019, pp. 37–38.
Diesel Emissions Justice Foundation, “News,” webpage, undated. As of October 5, 2020


ne per i vertici di Volkswagen Italia,” La Repubblica, April 20, 2020.
Fundação Procon–São Paolo, “Empresa utilizou software que mascara emissões de gases na Amarok,” November 15, 2015. As of October 2, 2020: https://www.procon.sp.gov.br/procon-s


page, undated. As of October 6, 2020: https://jade.io/j/
Justice Québec, “Fonds d’aide aux actions collectives,” homepage, undated. As of October 2, 2020:
http://www.faac.justice.gouv.qc.ca/
Kalajdzic, Jasminka, Peter Cashman, and Alana Longmoore, “


Massachusetts A.G. Healey, Maryland A.G. Frosh Announce Suits Against Volkswagen, Audi and Porsche Alleging They Knowingly Sold over 53,000 Illegally Polluting Cars and SUVs, Violating State Environmental Laws,” press release, July 19, 2016b. As of O


r-Fees-for.pdf
Organización de Consumidores y Usuarios de Chile, “Quiénes Somos,” webpage, undated. As of April 26, 2021:
https://www.odecu.cl/quienes-somos/
76
Bibliography
 Parliament of Australia, “Litigation Funding and the Regulation of the Cl


rofits and Pride at Stake, the Race for a Vaccine Intensifies,” New York Times, May 2, 2020.
Settlement Class Counsel’s Statement of Additional Information Regarding Prospective Request for Attorneys’ Fees and Costs, In re Volkswagen “Clean Diesel” L


d in VW ‘Dieselgate’ Case,” BBC News, April 6, 2020. As of October 5, 2020:
https://www.bbc.com/news/business-52184229
United Nations Economic Commission for Europe, Regulation 83, Uniform Provisions Concerning the Approval of Vehicles with Regard to


1-7-milliarden-euro/24457804.html?ticket= ST-209253-gIbVvEiCIaFkghvWLD69-ap1
“VW Faces ‘Dieselgate’ Lethal Threat in France,” The Connexion, January 27, 2020. As of October 5, 2020: https://www.connexionfrance.com/French-news/Car-manufacturer-Volkswa


 Community Supervision in a
Digital World
Challenges and Opportunities
Joe Russo, Michael J. D. Vermeer, Dulani Woods, and Brian A. Jackson
Delivering effective community supervision services has always been challenging; however, recent societal shif


ools should be devel- oped. These tools should be designed for nontechnical officers to scan the spectrum of electronic devices (e.g., smartphones, tablets, computers). Tools must be free
or low-cost and sustainable (e.g., supported, regularly update


rvision tool. Specifically, policy guidance and training are needed to high- light the issues surrounding monitoring individuals’ activity on these sites (e.g., what the benefits are, when it is appropriate, what the proper techniques are, what the p


hat stakeholders (e.g., legisla- tors, judges, prosecutors)—whose decisions affect how community supervision agencies apply digital management strategies—require better education. For example, broad-brush bans on accessing technology might be unreali


e, computer-facilitated crime is growing rapidly. According to the Federal Bureau of Investigation’s (FBI’s) Internet Crime Com- plaint Center, more than 460,000 complaints were received
in 2019, an increase of nearly 33 percent from the previous yea


lectronic devices.
These special conditions of supervision serve as guidelines that set the stage for specific digital management strategies
to help deter or detect criminal activity and/or behaviors that violate the conditions of supervision.1 Furth


g officers in the same agency. In the following section, we describe the most common digital management strategies cur- rently in use. It is important to note that the approaches are not mutually exclusive, but instead might be used in combination ba


s, can be very time-consuming. Some community supervision agencies have this capability internally. For example, in 2017, the Administrative Office of the United States Courts launched a national laboratory that serves federal
probation and pretrial


essag-
ing and chat logs, file-sharing activity) of the device and will report any violations or keyword “hits” to authorities. These systems are capable of blocking unauthorized sites and detect- ing attempts to tamper with or delete the monitoring


the presence of the supervisee). Monitoring an individual’s SNS activity can be time-con- suming because of the number of sites used and the volume of information shared. Automated tools are available that monitor the internet for references to spec


 ignored; it must be managed.
Although sex offenders and cybercriminals are the groups that are most likely to have computer-related supervision condi- tions, not every individual in these groups poses the same cyber risk. Furthermore, all supervisee


ficer knowledge of technology, search and seizure techniques, monitoring techniques, general versus spe- cific supervisee population issues, improvement of exist- ing tools, comparative evaluations of existing tools, the need for new tools, developme


See Figure 2 for the distribution of the needs across the five themes. The full list of needs can be found in the technical appendix.
Overall, more than one-third of all of the needs identified were related to the tools and training required to effec


required to perform advanced digital management techniques (e.g., forensic examinations, cloud investigations). Many agen- cies lack the internal capacity (e.g., trained staff, tools, infra- structure) to perform these functions, and they might not b


s key objectives; range of management, monitoring, and supervision options; model policies and procedures; legal issues; required tools and infrastructure; and staffing and training needs.
• Develop case studies to promote the benefits (e.g., cost-sh


agement that is required for supervisees.
There is a dearth of evidence around the effectiveness of digital management strategies.
• Develop best practices, policies, and templates for a digital intake process (and periodic updates) that includes all


ish a supervisee’s individual baseline for cyber risk. This baseline could be informed by relevant information, such as
an inventory of electronic devices an individual owns or to which they have access; software or applications to which they have ac


vices
(e.g., smartphones, tablets, computers). These tools should be designed specifically for community supervision purposes and should allow a nonexpert officer to quickly scan a device and create a report of key findings. Furthermore, these tools


e.g., friends of friends), and protects the officer’s identity. According to the participants, specific guidance is needed regarding how information found online may be used in court proceedings (e.g., authentication); they noted that some judges do


society.
The participants argued that stakeholders (e.g., legislators, judges, prosecutors, supervision agencies) need education high- lighting the importance of managed access to technology for prosocial activities, as opposed to outright bans. Stak


roups (e.g., sex offenders, gang members, violent offenders, financial criminals).
The participants recognized that identifying the most- appropriate measures of effectiveness will be challenging. In general, the more intensive the management approac


oads, it is
no longer possible to provide effective community supervision without accounting for how individuals interface with the digi- tal world. Effective digital management strategies that are based on risk can deter and detect criminal behavior


ent additional details about the workshop agenda and the process for identifying and prioritiz-
ing technology and other needs related to community supervi- sion in a digital world. Through this process, we developed the research agenda that structur


t the findings. The process typically elicits opinions from a relatively small group of experts. As a result, we strive to make the group as repre- sentative as possible of different disciplines, perspectives, and geographic regions. However, the fin


tionality from Turning Tech- nologies). We asked each participant to score each need and associated strategies to address those needs using a 1–9 scale for two dimensions: importance and probability of success.
For the importance dimension, participa


 the respon- dents and used that as the group’s collective expected value score for the need.
We clustered the resulting expected value scores into three tiers using a hierarchical clustering algorithm. The algorithm we used was the “ward.D” spherica


mine the point value of a single vote, we divided the full range of expected values by the number of participants voting.
To prevent the (somewhat rare) situation in which small numbers of votes have an unintended outsized impact—for example, when so


y of the needs to change their position within the second-round tiers. The output from this process became the final ranking of the panel’s prioritized results.
The complete list of identified needs is shown in Table A.2, and the needs are sorted by


ble to upvote items in that tier).
 20
Figure A.4. How a Need’s Increase in Expected Value Might Result in Its Movement Across Tier Boundaries
Higher score
Tier 1 score range
1
   1
1
   2
   Tier 2 score range
22
2
  2
  Lower score
Tier 3
score 333


.g., what to look for while conducting home visits, different types of storage media, indicators of multiple devices). Training should include approved methods of previewing devices in the field (e.g., manual scans, triage tools) and when and how to


ome try to avoid risks
by denying supervisees access to digital devices.
Need Tier
• Develop educational materials for stakeholders that illustrate the importance of managed individual access to technology for prosocial activities (as opposed to outr


ng opportunities to fully leverage the spectrum of supervisee digital information.
Agencies have incorporated digital management into comprehensive supervision approaches for some individuals (e.g., sex offenders), but similar principles have not bee


king site posts; conducting social networking investigations; or using tools to conduct point-in-time scans of devices, full forensic examinations, and the continuous remote monitoring of devices.
2 For example, the Nevada Department of Public
Safety


port on Public Safety: Tools and Strategies to Help States Reduce Crime, Recidivism, and Costs, New York, July 31, 2018.
Dance, Gabriel J. X., and Michael H. Keller, “Tech Companies Detect a Surge in Online Videos of Child Sexual Abuse,” New York Tim


nta Monica, Calif.: RAND Corporation, RR-A108-8, 2021. As of June 10, 2021: https://www.rand.org/pubs/research_reports/RRA108-8.html
Johnson, Derek B., “Congress Targets COVID Cyber Fraud,” Federal Computer Week, June 17, 2020. As of November 6, 2020


o Address Current and Emerging Concerns, Santa Monica, Calif.: RAND Corporation, RR-2933-NIJ, 2019. As of June 10, 2021: https://www.rand.org/pubs/research_reports/RR2933.html
Tanner, Jim, “Beyond Prosecution: Improving Computer Management of Convict


is a quantitative analyst adept at data acquisition, transformation, visualization, and analysis. His research typically focuses on justice and homeland security policy. He began his career as a Coast Guard officer on afloat and ashore assignments i


sing Evidence-Based Practices, Santa Monica, Calif: RAND Corporation, RR-A108-5, 2020
• Brian A. Jackson, Michael J. D. Vermeer, Kristin J. Leuschner, Dulani Woods, John S. Hollywood, Duren Banks, Sean E. Goodison, Joe Russo, and Shoshana R. Shelton,


Corporation
www.rand.org
The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpar


Evaluating Baltimore’s
Aerial Investigation
Research Pilot Program Interim Report
ANDREW R. MORRAL, TERRY L. SCHELL, ROSANNA SMART, BRANDON CROSBY, JUSTIN LEE, ROSE KERBER
 Sponsored by Arnold Ventures
SOCIAL AND ECONOMIC WELL-BEING
 For more informa


out their experiences with the program and (2) an analysis of cases that closed after receiving AIR evidence.
This report might be of interest to policymakers and the public interested in Baltimore’s experience using increased surveillance as a means


... 19 CHAPTER FIVE
Survey of Detectives’ Experiences with the AIR Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 CHAPTER SIX
Review of Cases Closed with AIR Evidence . . . . . . . . . . . . . . . . . . . .


racial justice protests across the United States, the Baltimore Police Department (BPD) began a six-month pilot program of an aerial sur- veillance program designed to help detectives solve cases of serious violent crime in the city. Arnold Ventures


was never operational in the program because of the time that it took to install cameras and acquire Federal Aviation Administration permits. Therefore, from June 17 until the end of the program, two planes took off around 9:00 a.m.,
ix
 Plane may re


provisionally solved rates describe the percentage of the next higher-level total represented by the corresponding count. For instance, 157 crimes with AIR evidence is 10 percent of all MOU crimes, and 42 provisionally cleared cases with AIR evidence


.
Because systematic differences could affect clearance and solve rates between cases with and without AIR evidence, simple comparisons of rates between these two groups are difficult to interpret. A more interpretable comparison would be between AIR


he program, but the program could have a much broader range of effects, such as deterrence, that should be considered in a full evaluation of its value. Third, if AIR evidence causes a reallocation of police resources from non-AIR cases, examining th


ze (8.0 per 1,000 population).
In recent years, many murders and other serious crimes in Baltimore have gone unsolved, meaning that police have not been able to clear the crime with an arrest. Whereas U.S. cities
1 The UCR definition of violent crime


and had real-time access to the computer- aided dispatch 911 and CitiWatch camera systems (Police Foundation, 2017). All calls for service were considered potentially eligible for PSS review, although violent crimes were said to be prioritized (Polic


eighborhoods, but across a wider portion of the city (described either as more than 90 percent of the city or as cov- ering an area over which 92 percent of the prior year’s homicides occurred).
• With rare exceptions approved by the Commissioner, th


the Schaefer Center at the University of Baltimore of public opinion of the program when it was first launched and after the program completed (Cotten et al., 2020), and a study by the RAND Corporation of the implementation and effectiveness of the


six months. The program involved collaboration between the BPD, PSS, several evaluation teams, and (to a lesser extent) the State’s Attorney’s Office, which handles prosecutions in Baltimore. Financial support from Arnold Ventures was used to pay PS


and the procedures for making such requests.
In the original plans for the AIR program, three manned aircraft equipped with powerful cameras would fly above the city during daylight hours, capturing a second-by-second record of outdoor events. Imager


 shows detail resolution when AIR analysts increase magnification on a location. The object in the lower left corner of the larger image is the wheel of the aircraft.
a request for AIR investigation (see Figure 2.4). AIR analysts would then examine a


s.
Together, these activities and the AIR evidence packages were expected to improve the BPD’s investigations of violent crimes, increasing the rate at which the BPD cleared serious crimes by arrest. AIR evidence could also help the BPD close cases f


icy decisions about the program and to identify and resolve new and ongoing challenges. The twice-weekly schedule was gradually reduced to a once-weekly schedule, with larger meetings held once every two weeks for the duration of the program. RAND an


micides that occurred while the aircraft was flying were at locations captured by the aircraft. During the final four months, when two aircraft were available, 66 percent of homicides that occurred while aircraft were flying were in a location covere


ly identifiable information and criminal justice information protected by law on a broad set of incidents, not just MOU crimes. Giving such information to a contractor could raise privacy concerns and questions about why a program limited to MOU crim


challenges had been addressed, the BPD opened AIR evidence requests to detectives in the Sex Crimes Unit. This occurred after detectives noted that many of the sex crimes that they were investigating also involved armed robberies, an MOU crime eligib


of when or where the crime was committed. At the same time, the BPD had all unsolved MOU crimes from May and June identified and forwarded to the AIR program for review.
The MOU allowed the possibility that AIR review might be requested for incidents


were in place for ensuring that the AIR program was notified to begin review of these cases.
17
CHAPTER FOUR
MOU Crimes and Case Dispositions During the AIR Program
During the six-month AIR program, 1,516 MOU crimes were reported across the city of B


e these crimes, they are excluded here. The five added cases appear in the latest data set that we received from the BPD but were not available when we conducted our analyses for the preliminary findings report.
  19
Evaluating Baltimore’s Aerial Inv


and homicides are cleared at a higher rate than other MOU crimes. Therefore, we would expect cases with AIR evidence to have a higher clearance rate, even if AIR had no effect on clearance rates. Other factors, such as the weather, the day of the we


timate the effects of AIR evidence packages on this subset of cases by excluding from the analysis all cases that close on the day of the crime or the next day. Therefore, using just the cases that did not close within one day, we compared clearance


eceived at least one AIR evidence packet. Most of the survey questions about the strengths and weaknesses of the AIR program were limited to this subset of 24 respondents.
This survey has a small sample size; the margin of error for percentages calcu


cene of crime” was the most commonly selected response, while “identifying a key witness” was the least selected option. Relatedly, when asked whether AIR evidence had ever arrived after they had already solved the case, about half of respondents ind


ing responses about the utility of these improvements:
• “Extending program coverage to include nighttime hours” (18 responding “much more useful”)
• “Increase video resolution” (18 responding “much more useful”)
• “Expand coverage areas to reduce ga


se that had closed and had an AIR evidence packet as of mid-November 2020. Lieutenant Brett Parson (retired) of the Metropolitan Police Department of the District of Columbia reviewed case records and evidence packages posted to the BPD’s Lotus Notes


e received from the program.
Therefore, of the 47 cases that closed and were worked by the AIR program, there were seven in which detective notes in the investigation database system indicated that the AIR evidence was “helpful” (five cases) or “crit


he BPD in time for it to be included in this report.
29
CHAPTER SEVEN
Discussion
The AIR program launched before its requisite systems (including aircraft), detective train- ing, and policies and procedures were fully developed and operational. The p


me reduction benefits in certain settings (e.g., parking lots) and for certain crime types (e.g., motor vehicle thefts), although findings are not always consistent across studies (Lim and Wilcox, 2017; Piza, 2018; Piza, Caplan, and Kennedy, 2014a),


t be interpreted as a conclusion about the overall effectiveness of the AIR program for several reasons. First, the strategy that we used to match non-AIR cases to AIR cases has limitations. Although the matched cases do, on average, occur at times a


dies suggest that the benefits of CCTV for crime detection and enforcement derive in large part from the extent to which the systems are actively moni- tored and systematically integrated into routine law enforcement activities (La Vigne et al., 2011


es.
Identification of Cases
Cases were counted as MOU crimes during the program if they were classified as a homi- cide, a nonfatal shooting, an armed robbery, or a carjacking in the BPD’s Lotus Notes data system. This data system is used to record f


cs.
Propensity scores and corresponding weights were constructed using the twang package in the R statistical programming language (twang version 1.6; Ridgeway et al., 2020). For our analyses, propensity scores (p) are the probabilities that each cas


 Vol. 18, No. 3, 2019, pp. 525–551.
Cook, Philip J., and Jens Ludwig, “Policing Guns: Why Gun Violence Is Not (Just) a Public Health Problem,” Items: Insights from the Social Sciences, blog post, November 6, 2018. As of January 19, 2021:
https://item


tute Justice Policy Center, September 2011. As of June 2, 2021: https://www.urban.org/research/publication/evaluating-use-public-surveillance- cameras-crime-control-and-prevention
Lim, Hyungjin, and Pamela Wilcox, “Crime-Reduction Effects of Open-Str


t for Weighting and Analysis of Nonequivalent Groups: A Tutorial for the R TWANG Package, Santa Monica, Calif.: RAND Corporation, TL-136/1-NIDA, 2014. As of July 15, 2021: https://www.rand.org/pubs/tools/TL136z1.html
Welsh, Brandon C., and David P. F


   CORPORATION
JASON M. WARD
The Effects of Project Labor Agreements on the Production of
Affordable Housing Evidence from Proposition HHH
Research Report
  For more information on this publication, visit www.rand.org/t/RRA1362-1.
About RAND
The RAND


ombining housing and labor policies. Consistent with the RAND Corporation’s mission to provide rigorous, objective, nonpartisan research and analysis, all the data and code related to this project is being made publicly available so that interested r


riencing homelessness. Extensive publicity during the campaign for the ballot measure suggested the funding would support the creation of up to 10,000 housing units. However, at present, virtually all funding has been committed, and a total of around


. As regards another potential motivation for the use of a PLA, ensuring a fair wage for workers, it is important to note that all developers of HHH-funded projects are required to pay workers “prevailing” (union-level) wages that are specified annua


 In contrast, there was one proposed project falling between 65 and 69 units.
vi
Figure S.1. Frequency Distribution of Project Sizes for HHH-Funded Projects
   Threshold for PLA
      20
Number of projects
10
5
0
5 20
15
 35 50
65 80 95
110 125 140 1


 foregone profits related to higher costs would create incentives similar to what might be expected of developers of market-rate housing.
Developer concerns about the PLA adding uncertainty over costs and timelines may
have been an important factor.


t this achievement has been overshadowed by the impression that HHH has failed to deliver on its
1 “Permanent supportive housing” (or sometimes simply “supportive housing”) is a broad term used to indicate housing units intended as permanent residenc


 of total costs. The small size of this share in the high-cost environment of Los Angeles is driven by the fact that a number of
2 Most projects only have estimated costs at this time since they are either in the pre-construction or construction phas


s among HHH projects has focused primarily on non– construction-related channels. A recent report from Abt Associates pointed to fiscal factors such as the 2017 federal tax reform bill that diminished the value of the low-income housing tax credit (L


 important ramifications for the effectiveness of Proposition HHH, the PLA was not included in the language of the ballot initiative.6
• During the debate between developers, trade union representatives, and the city over the structure of the PLA, no


dely used in the public sector for large-scale, government-funded projects (General Accounting Office, 1991). In recent decades, PLAs governing public works projects (such as the HHH PLA) have increasingly included language prescribing various levels


disadvantaged (or “transitional”) workers from within these residential areas. Among residents, two tiers of transitional workers are defined. The first is veterans and those with a history of criminal justice involvement. If individuals meeting thes


e built are
7 The HHH PLA also has a $5 million total development cost threshold for facilities improvement projects (work that is ancillary to the main buildings containing housing, such as site improvements), but this report focuses on housing proj


 controversial and relatively scant.
The lack of clarity around how PLAs affect competitiveness, costs, and other aspects of public works projects has two key drivers. The first is the difficulty of finding real-world settings where conditions allow


stipulations related to travel, holidays, and overtime) as well as differences in overall staffing levels and worker roles on the job site that affect costs (e.g., nonskilled tasks such as moving materials being performed by apprentice or journey-le


ess, among the studies conducted or funded by organizations with a policy position on PLAs, the findings are, in every case,
10
strongly aligned with the policy positions of the organization, an association that does
little to contribute to the quali


e associated with 25 percent higher construction costs (Bachman and Tuerck, 2006).
A critical weakness of this series of studies is that projects subject to a PLA may differ in important ways—such as geographic differences in construction costs and d


t and became statistically insignificant, suggesting that much of the estimated PLA association likely represented aggregated cost factors unique to Los Angeles.
A pro-PLA 2015 working paper that is perhaps most conceptually relevant to the present s


rence in the number of bids between PLA and non-PLA projects. For reasons not made entirely clear in the report, the authors used an unconventional analysis that make these findings difficult to directly compare with other analyses.11
Evidence on the


als and outcomes, approximately 50 percent of worker/hours goals were met under local hire programs outside of a PLA, while approximately 33 percent of worker/hours goals were met under THPs in a PLA.
Table C.1 presents all the main findings from the


t is the nature of the threshold that triggers a project falling under the HHH PLA—whether it comprises 65 or more housing units. Typical PLAs associated with the construction of a given project or set
13 As discussed below, I also control for potent


of Los Angeles comprised 111 HHH projects and 34 non-HHH projects. Of the 111 HHH projects, 13 were non-new construction (either partially or completely rehabilitation of existing housing). These projects were dropped, so the resulting full analysis


g the size of the standard errors but not the sign or magnitude of the estimate (Wooldridge, 2020).
Evidence on the Comparability of the HHH and Non-HHH Data Samples
The validity of this study hinges, in significant part, on the comparability of the


ogram, Home Investment Partnerships Program) and LIHTC funding. These soft loans, which tend to have generous terms and take junior positions in terms of repayment relative to other funding sources, must generally be procured first and are often scar


uction type) that also incentivize the proposal of projects of just under 65 units. To provide evidence on the plausibility of such a scenario, we can consider how the distribution of HHH-funded projects by size compares to the distribution of the sa


ests that the disproportionate number of HHH-funded projects proposed to be between 60 and 64 units is directly related to a desire by developers to avoid the PLA. In Chapter Six, I develop a simulation exercise in order to estimate how much the agre


on.
Basic cost tabulations showing how project size is associated with costs for HHH-funded and non–HHH-funded projects can help to illustrate this concept. Panel A of Figure 5.1 presents unit costs according to four groupings of project size for the


o 60 units or going from 70 to 100 units is associated with a per unit construction cost decrease of $6,960.
By construction, the fitting of a single line to the data does not allow for the estimation of potential differences in construction costs as


rcise is simply to
  26
provide the intuition behind the regression modeling approach used. The model used to generate the actual cost estimates in this report—described below and in more detail in Appendix B— simultaneously uses the discontinuity-ba


phical example in panel B of Figure 5.2 above) are:
20 Recent examples of this approach include Lemieux and Milligan (2008) and Cellini, Ferreira, and Rothstein (2010).
 27
• the number of stories
• whether a project is subject to a requirement to pa


endix B.
 28
interpreted in terms of an approximate percent change in construction costs associated with the HHH PLA.22
For each panel, I present the results of three specifications of the model. A brief explanation of each of these follows:
• Specif


the overall explanatory power of the model (measured using adjusted R2) from 0.64 to 0.74.23 Specification 3, which excludes projects from 64 to 74 units under the assumption that these projects near the PLA threshold were more likely to have their s


t or more of the sample data, suggesting a persistent, robust statistical relationship.24
Appendix B contains a wealth of additional material relating to these estimates. Tables B.1 and B.2 present results for each specification with coefficients and


increased PLA cost in percent terms relative
Figure 5.3. Interpreting HHH PLA Cost Estimates by Comparison with Larger Non-HHH Projects or Smaller HHH Projects
  20
15 Percent increase in construction costs 10 5
0
Non-HHH (65+ units)
HHH (50-63 units


 results (around 21 percent) found in this body of past research.
One useful falsification test for these results involves using soft costs instead of construction costs as an outcome. While soft costs are indirectly related to construction costs thr


syncratic nature of the PLA threshold, factors likely to significantly bias the estimated PLA effect would have to be explicitly correlated with project size around the PLA threshold or would have to be correlated meaningfully with construction costs


LA status. Due to their sizes, they are only used in draws for the static shares of projects of between 95 and 109 units and 110+ units. Their inclusion is motivated by increasing the pool of projects of different sizes available for drawing simulate


 them in a counterfactual setting where there was no HHH PLA.
Table 6.2 presents the results of this simulation. The first column shows the total number of units, the per unit construction cost, and the total per unit cost of the projects in the HHH


ld decline by approximately 1.5 percent across all units produced. Note that these differences reflect changes in cost averaged across all HHH projects in the absence of the PLA, not only projects covered by the agreement.
Since this simulation uses


ull HHH Pipeline
    Scenario 1
Scenario 2
          Additional housing units
Total housing units produced
Total cost savings (millions)
Percent increase in total housing units
Observed HHH Pipeline
7,305
Housing Output and Associated Savings
666 7,9


ring in mind as this and other research focuses on using the lessons of HHH to improve the effectiveness and transparency of future large-scale fiscal policies to address the housing affordability and homelessness crises in Los Angeles.
Summary of St


ack” multiple funding sources (i.e., use them together on one project), a feature common to a number of state-run funding programs in California, may significantly constrain the overall maximum costs of a project (California Department of Housing and


group that is unionized.
If, instead, a primary policy goal is to ensure that publicly funded housing is built primarily or exclusively using a unionized workforce, then directly including such language in future ballot initiatives or other proposals


pondents identifying as ethnically Hispanic and non-white, as is the case in the ACS).
Why Do These Findings Matter?
In the near term, the cost estimates in this report may aid in ongoing decisions regarding the expenditure of any remaining HHH funds


or utilization
• generating meaningful evidence on the landscape of hiring and utilization of local and disadvantaged workers in the construction trades on non-PLA job sites and how this compares to job sites governed by a PLA or related regulations


ulations from city of Los Angeles, TCAC, and CDLAC data.
NOTE: Standard deviations for each measure in square brackets. Two projects with a CA Department of Industrial Relations PLA status that does not follow the 65+ threshold rule are omitted.
45
[


between the time that cost estimates were provided for obtaining LIHTC funding and when they were provided to the California DIR. The fact that these cost estimates appear to vary little between when data are provided to the state committees allocati


ontribute to the average costs of projects that were subject to the PLA. This exclusion does
not qualitatively influence the cost estimates discussed. Its effect on construction costs is demonstrated in Table A.2. Panel A replicates the construction


ured either in $1,000s or the natural log of $1,000s—for project " estimated in year # on a binary indicator variable for using HHH funding, a binary indicator variable for the project comprising 65 units or more of housing, and the interaction betwe


would result in an estimate that would be biased downward in magnitude (toward zero). On the other hand, it might also be the case that developers who were more aware of the presence and implications of the PLA chose to build below the threshold, whi


• Stories/construction type. The number of stories can influence project size by directly increasing costs. As stories increase, different building types must be used (e.g., wood over a concrete foundation versus steel construction). However, it can


larger buildings, which are more likely to have this amenity. For this reason, I do not focus on the specific magnitude of this (and other coefficients) per se, but consider whether (a) they improve the overall fit of the model and (b) they improve t


s that does not follow the 65+ threshold rule are omitted (see Appendix A for details). In specification 2, outlier projects are those below the 5th percentile or above the 95th percentile of project size. Standard errors in parentheses.
+ p<0.10,* p


** p<0.01.
Table B.5. Estimated PLA Cost Effect Using Quadratic Modeling of Unit Size
      HHH PLA
Observations Adjusted R2
Single Quadratic Specification
44.877* (21.017) [0.037]
86 0.735
Independent Quadratic Terms Above/Below Threshold
45.457* (2


 TCAC, and CDLAC data.
   63
         Table C.1. Summary of Past Studies of Targeted Hiring Provisions with PLA Status
                Jurisdiction PLA
City of Cleveland
City of Oakland
City of Richmond
West Contra Costa USD
City College of San X Fra


ners 1
D. L. Horn & Associates, LLC 2 Daylight Community Development 2
DDCM Incorporated 1
Decro Corporation 4
 Deep Green Housing and Community Development
1 1
Domus GP, LLC 4 EAH Housing 3
 East LA Community Corporation
1 2
Flexible PSH Solutions 2


nstitute, New York State Dormitory Authority Construction Project,” 1995. As of May 4, 2021: http://thetruthaboutplas.com/wp-content/uploads/2012/12/Roswell-Park-Cancer-Institute -NY-Letters-on-PLA-Cost-Increases-1995.pdf
Bachman, Paul, William F. Bu


se/Home/California/CaliforniaCodeofRegulations?gui d=I47630370D45A11DEA95CA4428EC25FA0&originationContext=documenttoc&transitio nType=Default&contextData=(sc.Default)
California Department of Housing and Community Development, “Multifamily Housing Pr


nning.lacity.org/StaffRpt/InitialRpts/CPC-2017-3136.pdf
———, Rules and Regulations: Implementing the First Source Hiring Ordinance, Los Angeles: Bureau of Contract Administration, Office of Contract Compliance, 2016.
City of Los Angeles Department of


ifornia Environmental Quality Act Lawsuits and California’s Housing Crisis,” Hastings Environmental Law Journal, Vol. 24, No. 1, 2018, pp. 21–71.
Holland, Gale, “L.A. Officials Launch Campaign for Homeless Housing Bond Measure,” Los Angeles Times, Se


rnia Needs More Affordable Homes. This Union Stands in the Way,” Wall Street Journal, April 17, 2021. As of May 4, 2021: https://www.wsj.com/articles/california-needs-more-affordable-homes-this-union-stands-in -the-way-11618660801
Martindale, Scott,


UC Berkeley Labor Center, 2017. As of May 20, 2021: https://laborcenter.berkeley.edu/project-labor-agreements-and-bidding-outcomes/
Raetz, Hayley, Teddy Forscher, Elizabeth Kneebone, and Carolina Reid, The Hard Costs of Construction: Recent Trends in


HH,” Santa Monica: RAND Corporation, 2021. As of July 23, 2021: https://github.com/RANDCorporation/HHH-Project-Labor-Agreements
Warth, Gary, “Gov. Newsom Proposes $12 Billion to House California’s Homeless,” Los Angeles Times, May 11, 2021. As of Jun


Project imPACT Cohort 1 Final Local Evaluation Report
STEPHANIE BROOKS HOLLIDAY, ALFONSO MARTIN, KATYA MIGACHEVA, AMY GOLDMAN, NICOLE BRACY, VERONICA AWAN, SARAH B. HUNTER
 Sponsored by the Los Angeles Mayor’s Office of Reentry
SOCIAL AND ECONOMIC WE


or who are currently on community-based supervision who also have a history of mental health and/or substance use concerns. This program provides employment, behavioral health, and legal services in an effort to help participants obtain and retain e


. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Evidence Base for Employment-Focused Programs for Justice-Involved Individuals. . . . . . . . . . . . . . . . . Program Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


ct imPACT Completion Status . . . . . . . . .
5.1. Barriers to Service Delivery and Uptake. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2. Barriers Precipitated by the COVID-19 Pandemic. . . . . . .


laboration, (b) trauma-informed care, (c) cultural competence, and
(d) focus on the Fellow
4. improved employment outcomes
5. reduced recidivism.
RAND Corporation and Harder+Company (the evaluation team) conducted a mixed
methods process and outcome


ed, two of these outcomes (those related to employment and recidivism) overlap with the overarching project goals established by the Mayor’s Office. The other two outcomes (improved decisionmaking and addressing barriers to employment) are based on t


ion data
Lack of physical space for services
Insufficient training on topics such as trauma-informed care, or refresher trainings for CBT
Fellows have some remaining unmet needs, such as limited access to transportation, housing, or medical care; lac


0 percent of Fellows to either correct, remove, seal, or expunge their rec- ords, or to take initial steps in that process (for those who were not yet eligible for expungement).
With respect to employment, a total of 192 Fellows obtained employment.


There are some opportunities for improvement, though. For example, providers described a need for additional training, and coronavirus disease-19 (COVID-19) presented key challenges to serv- ing Fellows—particularly given technology-related challenge


s
Though Cohort 1 of Project imPACT has ended, the program continues to serve Fellows through Cohort 2. The program has demonstrated promise and ongoing data collection during
Summary xiii
xiv Project impact Cohort 1 Final Local Evaluation Report
Coh


portunities to reduce burden on the providers, such as through development of a new case management system that providers can use for ser- vice provision and we can use to extract evaluation data. This will include elements to assist providers in the


criminal justice system, with priority given to programs that “reduce recidivism of people convicted of less serious crimes (such as those covered by Proposition 47) and those who have substance abuse and mental health problems” (Taylor, 2015, p. 8)


lar for formerly justice-involved indi- viduals and nonjustice-involved individuals (Formon, Schmidt, & Henderson, 2018). Starting salaries were also similar. A recent review described the findings of several randomized controlled trials of programs


odels of employment services in several ways. First, Project imPACT was designed to serve individuals who have a history of mental health conditions and/or substance use disorders. Second, Project imPACT was designed as a wraparound service model. Th


hort-term, Project imPACT aims to improve participant decisionmaking, via the CBT curriculum, and address barriers to employment, through the employment, legal, and behavioral health services. It is expected
Project Description 3
4 Project impact Coh


uilds on an interim report published in late 2019 describing the early stages of Project imPACT (Brooks Holliday et al., 2019). The previous report described the planning phase (February 2018–July 2018) of Project imPACT in detail. It also described


ellows satisfied with their experience in Project imPACT?
In addition to providing detail about implementation, the process evaluation was impor- tant for interpreting results of the outcome evaluation; for example, if no effect of the program
1 Most


us disease-19 (COVID-19). One of the researchers on the team reviewed data from these sources and thematically organized them within a struc- tured grid, which incorporated such categories as barriers to implementation, facilitators of the implementa


provided information to program providers on who should be invited to participate in the interviews, the purpose of the interviews, and frequently asked questions. Potential interview participants were asked to share their contact information and the


Fellows are satisfied with service delivery
Definition
Number of individuals assessed for Project imPACT
Number of individuals enrolled in Project imPACT
Number of individuals assessed by service provider
Number of individuals receiving services by s


employment providers aimed for 55 percent of individuals completing the program to obtain employment. For others, such as rates of employment retention, we drew on the literature to determine how outcomes for Proj- ect imPACT fellows compared with th


yment at 6, 9, and 12 months after placement, by full-time and part-time employment
Percentage of Fellows convicted of a new crime, 6, 12 and 18 months after program completion
Notes for Measurement/ Timeline
To be measured at baseline, completion of


/seasonal employment. In addition, the Mayor’s Office set the goal of at least 55 percent of enrolled Fel- lows obtaining full-time employment. Therefore, employment rates were also compared with this benchmark. As a supplemental data point, provider


mploy- ment providers were meant to follow up with graduated Fellows at 6, 12, and 18 months to determine if they had been convicted of any new crimes in the last 6 months.4
Unfortunately, there were significant limitations to the use of self-reporte


Together, our process and outcome evaluation methods allowed us to measure progress toward each of the five Project imPACT goals described above. Table 2.3 summarizes each goal, how it was operationalized for the purposes of the evaluation, and whet


isting contacts and community-based organizations to identify potential Fellows. In some regions, the employment agency serves a broader range of clients, so a representative from Project imPACT would attend those broader orientations to describe the


ental health, and sub- stance use. Those who meet initial eligibility criteria are then assessed with the LS/CMI; the potential Fellows who are determined to be medium risk or higher are then eligible to enroll in Project imPACT.1 Participation in Pr


orkshop, a five-day course during which time they learned about the various program options offered by CEO, including Project imPACT. Those who were interested completed the eligibility assessment process and then began work with Project imPACT provi


- lows entered directly into an employment position, though some clients completed technical education courses first, such as welding, heating, ventilation, and air conditioning (HVAC), and hospitality-focused courses. Once Fellows obtained a job, th


aintenance services. Services are intended to address behavioral health concerns that may interfere with obtaining and maintaining employment, including anger management, depression and substance use, mental health stigma, and low self-esteem. Comple


advice, self-help, limited representation, and full representation. Completion of legal services was defined as having completed the comprehensive legal needs assessment and having one or more of their legal needs addressed (note: this does not neces


e program), and helping Fellows schedule appointments and connect to other types of needed services (e.g., DMV appointments, health care appoint- ments). One peer navigator highlighted the value to having a staff member in the program who had lived e


e up sessions at a future date. At the beginning of the program, the curriculum was delivered in a variety of ways across regions, with some imple- menting the curriculum as an intensive two-week course and others offering it as a weekly or twice-wee


lients in online training sessions in lieu of in-person work crews and was eventually able to place Fellows on in-person work crews with additional safety precautions in place (e.g., mask wearing, physical distancing requirements). Some behavioral he


ed to serve as an eligibility screener, so this is one way that providers can determine if individuals are eligible for Project imPACT or not. When Fellows are not eligible for the program, they are generally referred to other resources, primarily ot


rvices ended. Fellows largely scored as medium (44.7 percent) or high (44.4 percent) risk on the LS/CMI. Fellows were predominately male (79.4 percent) and the largest percentage (57.4 percent) was between the ages of 26 and 43. Nearly all (96.3 perc


ate 0.9%
7.1%
      SOURCE: Data submitted by regional providers.
NOTE: The racial/ethnic categories were specified by the BSCC.
Table 4.4
Percentage of Fellows Receiving Services Across Regions
 Service Category
Employment Behavioral health Legal
Do


istration (OSHA) training, which was later expanded to include any vocational training; however, it is possible that this expanded definition was not used consistently, which would explain the small numbers of Fellows receiving vocational training se


 (4.9)
                Employment Services, Overall and Regional
Table 4.5
1.68 (1.23)
2.50 (1.52)
62 (60.8)
readiness
assessments
readiness
workshops
Career
Career
88 (88.0)
SOURCE: Data submitted by regional providers.
NOTE: SD, standard deviation.


e average number of sessions that Fellows received per month. These averages were calculated only for those who participated in a given service (i.e., the average number of monthly individual crisis sessions is based only on those who had at least on


 Fernando Valley (n = 54)
M (SD) No. of Hours
Receiving No./ Services Percentage
        Legal Services, Overall and Regional
Table 4.10
M (SD)
Hours
No. of
Downtown (n = 88)
Receiving
No./
Percentage
Services
Legal Service
Category of
representation


ompletion rate than San Fernando Valley (p<.05). The relatively higher rate of unsuccessful exits from the San Fernando Valley region may reflect some of the Fellows who were lost to follow-up during the transition of employment agencies. Providers d


t imPACT
24.60 (31.66) 3.02 (4.85) 1.72 (1.20) 24.50 (45.84)
  Association Between Use of Individual Services and Program Completion
We examined programmatic factors that may have contributed to a Fellow successfully com- pleting Project ImPACT. Firs


il in our interim report (Brooks Holliday et al., 2019). To better understand the facilitators and barriers to program implementation, we drew on interviews with staff members during site visits, information learned during our atten- dance at Project


l Health Services
Employment providers in all regions noted the great value in offering high-quality specialized legal and behavioral health services to their Fellows. Providers mentioned that the fact that legal providers and behavioral providers se


ation team, providers decided to offer a condensed, more intensive two-week course. These changes were executed to make it easier for Fellows enrolled in the program to fully participate in CBT and to serve as a demonstration of commitment to program


e.g., the CBT facilitation training), and there were not opportunities for these individuals to participate in the missed trainings.
Provider Perspectives on Program Implementation 37
38 Project impact Cohort 1 Final Local Evaluation Report
  Solutio


n when required by the court
Frame services as an opportunity to alleviate—not add to—pressures, meeting Fellows where they are, serving as Fellows’ support networks
Referral to relevant mental health resources
All N/A
Uptake
Severe mental health
cha


es or missing data arise. Throughout the project, members of the evaluation team also met with regional pro- viders to support their data reporting challenges, through either training or troubleshooting.
Following up with Fellows to capture their lon


hat access to transportation was a barrier for some of the Fellows that may have prevented them to engage in, complete, or fully benefit from Project imPACT. Most of the regions referred Fellows to external resources that offered transportation assis


- employment relationship) and appealed to prioritize adding housing as the Project imPACT component. As a result of multiple discussions, the Mayor’s Office created a housing services element, staffed by personnel from one of the behavioral health o


t the program establish or support special graduation ceremonies and certificates to celebrate Fellows’ accomplishments, recognize their ability to complete a program with many requirements, and elevate the prestige of the program. Some regions have


llow’s mental health symptoms became more acute while enrolled in services, behavioral health providers sometimes referred individuals to appropriate external resources. In these instances, Fellows were welcome to stay in Project imPACT as they were


tions and CBT, to job development and peer navigation, to legal counsel and behavioral therapy. However, without specific training, doing so was a challenging process that demanded rapid learning, trial and error, and adaptation to keep Fellows engag


enge for Fellows across different regions was the lack of private spaces that Fel- lows could use for engagement with different services within Project imPACT. Many Fellows lived in shared housing, including shared rooms. Further, lack of access to p


scribed, providers identified opportunities to further leverage community collaborations to offer additional supportive ser- vices to Fellows and/or raise the profile of Project imPACT in the community.
Trauma-informed care. All providers were acutel


ers to engagement arose, providers discussed their con- cerns with other providers and the Mayor’s Office to identify solutions. Providers made sure to create environments where Fellows did not feel judged or pressured to follow directions that were


 need for adequate training in trauma- informed approaches to work with reentry populations and the Mayor’s Office prepared to facilitate one such training at the time of the writing of this report.
Provider Perspectives on Program Implementation 47


1). The mean change was a decrease of 0.57 points. It should be noted that the majority of these Fel- lows were from South Los Angeles (n = 81), with the remainder from Watts (n = 10). Similarly, we examined the change in scores for the subset of par


I did initially.
It made me think different on the daily like, instead of doing something crazy, I’ll just go calm down, and relax and breathe and take a walk.
Other Fellows and alumni described an improved ability to identify their thinking pat- ter


d part time, and 3.7 percent were employed in a temporary or seasonal position (Table 6.5).
We found some significant regional differences in the rate of employment, with South Los Angeles having the highest employment rate (p<.05). South Los Angeles


) (32.3 percent) is nearly twice the percentage who exited without a job prior to COVID (July 2018–March 2020) (16.4 percent). This suggests that COVID pandemic may have had an effect on Fellows’ ability to find a job.
On average, Fellows participate


vices also appeared more likely to obtain employment (80.3 percent) than their non- completer counterparts (74.7 percent); however, this difference was not statistically signifi- cant. Those who completed legal services were about equally as likely t


viders was not able to reach (either because they attempted to reach the individual and were unsuccessful or did not attempt to reach the individual). At three months, 58 percent of Fellows were known to still be employed, and at six months, 60 perce


 legal services experienced a smaller increase in income (r = −0.27, p < .01).
Recidivism
Project imPACT providers assess recidivism when conducting regularly scheduled follow-ups with Fellows at 6, 12, and 18 months after a Fellow completes Project


to Cohort 2.
Outcome Evaluation Results 59
CHAPTER SEVEN
Client Perspectives
Gathering qualitative client feedback and experiences with Project imPACT is an important component of this evaluation. This feedback is solicited through semistructured foc


dedicated to success and accomplishing something and improving your life, Proj- ect imPACT is where you can do it.
Another shared:
My whole outlook was different when I came out and society had changed. Everything had changed and so I had to adjust.


ficult situations
• Better understanding of root causes of behavior and learning coping skills
• Opportunity to share thoughts and feelings in nonjudgmental space
• Convenienceofcolocatedservices
• No-cost legal services that address removing, sealin


ts to working with the peer navigator, who pro- vided a forum for sharing their experiences in a nonjudgmental space. As one alum indicated:
[Having a peer navigator] helped because you were comfortable to just say what you were going through and jus


 probably would have went back. I probably would have failed, if anything that were posi- tive. They talk to me as a person, not as an inmate, not as a prisoner, not as a convict. They treated me as a person. That’s what I loved about this program.
A


like family. By us not being able to see, talk, whenever. Sometimes it’s hard to get a hold on them. Maybe you’re trying this, but now you can’t. You can’t find nowhere or nobody or you can’t see nobody to get it out, so they don’t give you an input


d probation officers. Fellows also suggested having alumni share their success stories with new program participants to encourage them to remain in the program. As one Fellow noted, “people have achieved a lot and when you see one achieve, it makes y


artners who might serve as referral pipelines, including probation, parole, and other communitybased organizations serving justiceinvolved individuals. These recruitment and enrollment numbers demonstrate the effectiveness of these referral pipelin


has also been observed in other contexts in which behavioral health services are integrated with other care (e.g., Watkins et al., 2020). It will be important to ensure that the infrastructure exists to support all types of providers to be onsite, e


literature (e.g., Farabee, Zhang, & Wright, 2014; Redcross, Millenky, et al., 2012). More over, Fellows who completed employment services were more likely to be employed than those who did not. This suggests an association between participation in


, the Mayor’s Office collaborates with providers to develop solutions. A prime example is the establishment of housing services for
Summary and Conclusion 71
72 Project impact Cohort 1 Final Local Evaluation Report
employed Fellows. Our focus groups


were equipped to work with a diverse range of indi viduals. Some providers indicated that they were interested in training on this topic as well, though, including training on serving LGBTQ+ populations. Finally, both providers and Fel lows describ


e time, it is important to keep in mind that Los Angeles is an extremely high cost of living region, and the demand for affordable housing far outpaces the availability of such housing (California Housing Partner ship, 2020). In addition, the fair m


ay the importance of peer navigators to the program—in fact, providers described peer navigators as an essential part of their regional teams, and Fellows noted how valuable it was to have indi viduals with lived experience involved with the program


who successfully completed the program to those who exited before completion (e.g., with respect to volume of services received); however, we missed the followup data regarding employment and income outcomes for many of those who exited unsuccessful


iduals experiencing complex trauma, may also protect against burnout. In addition, though a certain level of turnover is inevitable, positions often were vacant for several weeks before being filled by a new staff member. Find ing ways to improve tr


s could integrate into their budgets if there is a need. Finally, the Mayor’s Office has sought opportunities to formally add additional services to the Project imPACT model. Spe cifically, after hearing the need for housing services, the Mayor’s Of


data collec tion requirements, with the goal of developing a robust evaluation approach that also limits burden on the providers. However, there are substantial quantitative reporting requirements for this work, and there are ongoing difficulties r


Proposals. Sacramento, CA: State of California. As of July 11, 2019: https://www.cacities.org/Resources-Documents/Policy-Advocacy-Section/Hot-Issues/Homeless-Resources /League-CSAC-Task-Force/May-11,-2017/7-_proposition_47_request_for_propsals_-_upda


ss youth in a substance use and HIV-risk reduction program. Field Methods, 30, 22–36.
Glaser, B., & Strauss, A. (1967). The Discovery of Grounded Theory: Strategies for Qualitative Research. Mill Valley, CA: Sociology Press.
Harder+Company (2015). Ce


fender employment programs and recidivism: A meta-analysis. Journal of Experimental Criminology, 1, 295–315.
Watkins, K., Hunter, S. B., Cohen, C. C., Leamon, I., Hurley, B., McCreary, M., & Ober, A. (2020). Organizational capacity and readiness to p


  CORPORATION
ASHLEY M. KRANZ, ANITA CHANDRA, JAIME MADRIGANO, TEAGUE RUDER, GRACE GAHLON, JANICE BLANCHARD, CHRISTOPHER J. KING
Assessing Health and Human Services Needs
to Support an Integrated Health in All Policies Plan for Prince George’s County


ssment in its pursuit of a Health in All Policies approach to policymaking. This assessment builds on the 2009 RAND assessment and other County reports to more deeply examine the drivers of health influencing health outcomes. The findings are based o


provided across many sectors in the County including human services, criminal justice, and schools. Yet, drivers of health largely exist outside of health care alone. While most adults in the County reported having good to excellent health, there ar


 County Residents in 2018, by Citizenship and Place of Birth ............... 181
7.7. Rates of ED Visits and Hospitalizations per 100,000 Population, 2017 ............................182
7.8. Most Common Reasons for ED Visits for Adults, Percentage o


020). Prince George’s County, which is predominantly composed of Black residents, accounts for more than one-in-four COVID-19 cases in Maryland (Maryland Department of Health, 2020). As of this writing, the County has reported the highest rate of COV


happening including national discussions regarding the increasing burden of chronic diseases, rising health care expenditures, and growing attention to the role of social determinants of health (SDOH). In this context, Prince George’s County is poise


oviders in DC
   Examines health care provision outside of traditional health care providers, including schools, fire/EMS and corrections
   Situates recommendations via Health in All Policies, inclusive of budget alignment and legislative action lev


commendations, we reviewed Prince George’s County’s operat- ing budgets from fiscal year (FY) 2007 to 2019 and proposed operating budget from FY2020 determine where funding was allocated across county departments. We also reviewed prom- ising practic


s a better option.
Spending on health and human services is low.
• Estimated County spending on health and human services departments is $39 per person, about one-third to one-seventh the per-person spending of surrounding Maryland counties.
Ineffici


lenges related to access to care and system confusion indicated by use of emergency services for non-urgent needs. Stakeholders expressed concern about access to care, frequently related to access to primary care and mental and behavioral health serv


therefore may be uncounted. Improvements were observed for school and public safety, with fewer high school students reporting sexual dating violence and a lower violent crime rate. However, self-reported data from middle school students suggests sa


s emer-
gency medical services from the Fire/EMS Department, health care offered by Department of Corrections, public safety supported by the Police Department, and environmental efforts from the Department of the Environment. This preliminary budget


ng new measurement and data systems. We use the acronyms LB and EB to help delineate primary roles for the County Board of Health (LB) versus activities of the Office of the County Executive (EB).
xxx An Integrated Health in All Policies Plan for Pri


alth, which produced a guide to help towns design health communities (Vermont Agency of Transporta- tion, 2019). Examples of using equity lenses on community investment and policy decisions include Multnomah County, Oregon, which developed the Equity


is essential for ensuring messages reach the correct populations. For example, communicating volunteer opportunities to seniors necessitates a different communication strategy than communicating about service availability to young adults.
2. Align In


s, focused on midstream and upstream determinants and drivers of health, which were then used to develop policy recommendations (Vermont Department of Health, 2018a).
2.3 Better coordinate the nongovernmental organizations that address health and hum


example, Santa Monica, California reports traditional health outputs and outcomes in physical, social, and emotional health in addition to broader well-being measures of community cohesion, the quality of the natural and built environments, and econo


red interest of leaders and residents to embrace a more inte- grated and holistic strategy for promoting health and well-being and addressing inequities in the County. This shared interest provides an excellent foundation for implementing and sus- ta


ergency department
EMS Emergency medical services
EPA Environmental Protection Agency
ERS Economic Research Service of the U.S. Department of Agriculture FQHCs Federally Qualified Health Centers
FTE Full time equivalent
FY fiscal year
HPSA Health Pro


ganiza- tions, and other service providers. In particular, there is a need to understand the full extent of the health issues in the County as well as where and how health is being influenced in order to inform recommendations for how the County proc


has been the trend across the United States, the hospital mergers and acquisitions have changed the County’s health care landscape (National Institute for Health Care Management Founda- tion, 2020). In 2019, Anne Arundel Medical Center and Doctors Co


ors in the County with clinical pharmacists to deliver care virtually, an approach known as “telepharmacy” (Council News, 2018). With a history of engagement in health promotion and at the cusp of a new hospital, the Board of Health is poised to purs


nering for Health Equity: Strategies, Partnerships and Recommendations for Immi- grants’ Health in Prince George’s County from La Clínica Del Pueblo (2018).
Maternal and infant health
• Maternal and Infant Health Report from the County Health Depart


l, economic, built, and natural environments.
 Offers insight into role of schools and human services departments in promoting health.
   Utilizes health care discharge data from both Maryland and District of Columbia (DC), highlighting key role of c


ommunity levels (Centers for Disease Control and Prevention, 2018). While the health care system is widely recognized as impacting health, public health systems are essential for promoting both individual- and community-level health by conducting hea


George’s County Administration Building in Upper Marlboro. An online survey was also used to capture comments from residents who were unable to attend this meeting.
• Three focus groups composed of 24 residents. These groups were distributed geograph


with attention to reflecting all areas of our framework and also to highlight indicators that have not previously been included in prior reports related to health needs in Prince George’s County. Together, these data describe drivers of health affec


findings by populations that have special needs, such as pregnant
women, seniors, and people experiencing homelessness.
• Chapter Seven provides several exemplars illustrating the linkages of drivers of health
and health outcomes for two populations


urveys (2014 to 2018).
11
12 An Integrated Health in All Policies Plan for Prince George’s County, Maryland Table 2.1.
Demographics of Prince George’s County Over Time, 2009–2018
 Year
 2009 2010 2011
24.7 23.7 23.5 31.7 33.3 33.3 34.1 33.5 33.4
9.4


ear Summary File, 2014–2018.
16 An Integrated Health in All Policies Plan for Prince George’s County, Maryland Table 2.3.
Demographics of Prince George’s County, by District, Pooled 2014–2018
 County Councilmanic Districts
PG 1 2 3 4 5 6 7 8 9
  Age


a very high proportion of foreign-born (48.2 percent) residents and the highest proportion of Hispanic residents (52.2 percent) compared to all other districts.
• District 3 has a higher proportion of White (21.8 percent) and Hispanic (27.2 percent)


d
• • •
• • •
Substance use disorder Sexual health
Maternal and infant health
After that, we summarize indicators of well-being, inclusive of
Health literacy Health behaviors Civic engagement
We end the chapter by sharing key themes that emerged duri


vior. Clinical care assesses a county’s accessibility to affordable and qual- ity health care. Subsequent chapters in this report focused on drivers of health will further describe the measures related to social and economic factors and the physical


derably lower rates of YPLL. Within Prince George’s County, the YPLL rate was greater for Black residents than White and His- panic residents.
Table 3.3.
Years of Potential Life Lost Rate per 100,000 by Jurisdiction and Race/Ethnicity, Pooled 2015–20


Death Rates
250
200 176 166 150
100
50 0
180 192
94
64 8064
SOURCE: Centers for Disease Control and Prevention, 2019b.
NOTES: Data was accessed from CDC WONDER in 2019 and represents 2017. Rates are age-adjusted and presented per 100,000 population.


re and having a medical home is a known challenge in the County Assessment (Prince George’s County Health Department, 2019b).
Figure 3.3.
Descriptions of Chronic Conditions
 Condition
  Description
  Prevention & Treatment
 Arthritis
 • Inflammation


 adults had higher rates of cardiovascular disease and diabetes than the state and nearby counties.
Table 3.5.
Self-Reported Health Status for Adults, by Jurisdiction, 2017
Measure
Self-rated health: Excellent, very good, or good
Diagnosed arthritis


For example, undiagnosed hypertension has been identified as a problem among immigrants in the United States with poor access to health care (Zallman et al., 2013).
Table 3.7.
Self-Reported Health Status for Adults in Prince George’s County, 2017
Dia


ction.
Cancer screening
In 2016, Prince George’s County had slightly higher cancer screening rates compared to the state for prostate, colorectal, and breast cancers, and slightly lower screening rate for cervical cancer (Table 3.8).
Table 3.8.
Self-


6 2007 2008
All Sites
Lung and Bronchus
2009
Breast Prostate
2010
2011
2012 2013 2014
Colorectal Cervical
      SOURCE: Maryland Cancer Prevention, Education, Screening and Treatment Program, 2017. NOTES: 2006 incidence rates are lower than actual du


rince George’s Maryland
154.1 154.3 25.8 21.5 13.2 13.19 16.5 16.3 10.9 12.0 31.9 37.0 38.0 44.1 27.3 31.8
SOURCE: Maryland Cancer Prevention, Education, Screening, and
NOTES: HP 2020 Goal, indicates the Healthy People 2020 goal which serves as a fed


c adults reported the highest rate of disabilities overall (42.1 percent) and had the highest rate of mobility disabilities (27.1 percent). Reporting a mobility disability was more common among adults who were less educated and lived in lower income


 diagnosed with depressive disorder than in other nearby counties or the state (Table 3.14).
Table 3.14.
Self-Reported Mental Health for Adults, by Jurisdiction, 2017
 Measure
Diagnosed depressive disorder
Reported days of “not good” mental health pa


t killing themselves
High School
Seriously considered attempting suicide
Felt sad or hopeless frequently
Bullying
Middle School
Been bullied on school property
Been electronically bullied
High School
Been bullied on school property Been electronicall


 Binge drinking is defined as drinking 5 or more drinks on an occasion for men or 4 or more drinks on an occasion for women.
Table 3.18.
Self-Reported Binge Drinking by Adults in Prince George’s County, 2017
Binge Drinking
Overall 12.8
Demographics
A


nce George’s County, Maryland, 2007–2017
3. Health and Well-Being 41
   Number of deaths
120
100
 80
 60
 40
 20
0
     2009 2010 2011
2012
2013
2014 2015 2016
Fentanyl-Related Heroin-Related Alcohol-Related
Opioid-Related
Prescription Opioid-Related


52 7,365 1,282 1,832 2,001 81 110 143
2018
8,013 2,020 153
Maryland
30,658 510.4
TB Prevention.
  SOURCE: Maryland Department of Health Infectious Disease Bureau, 2019. NOTE: *Includes both Primary and Secondary Syphilis.
Table 3.22.
Chlamydia Infect


omen, 21 per 1,000 for Black women, and 6 per 1,000 for White women.
44 An Integrated Health in All Policies Plan for Prince George’s County, Maryland
Table 3.23.
Teen Birth Rates (TBR) per 1,000, by Jurisdiction and Race/Ethnicity, Pooled 2011–2017


4.5
3.8
 SOURCE: Maryland Vital Statistics Administration, 2019.
NOTES: *Rates based on <5 deaths are not shown since rates based on small numbers are statistically unreliable.
Well-Being
Well-being encompasses the factors that describe a full and sa


teracy, an in person assessment of English language literacy among
a nationally representative sample of U.S. adults aged 18 and older. Full methods describing the modeling approach are included in the 2010 report by Lurie and colleagues (Lurie et al


ng County adults was lower than the state average and lower than rates in Howard and Montgom- ery counties, and the obesity rate was considerably higher among County adults.
Table 3.27.
Self-Reported Health Behaviors for Adults, by Jurisdiction, 2017


k and above Below $50k
Has a personal doctor Has a personal doctor No personal doctor
Consumed fruit one or more times per day
63.2
62.2 67.8
64.9 60.8
64.0 60.2 64.8
64.7 58.2
61.5 65.7
62.0 65.4
Consumed
vegetables one or more times per day
77.6
77


ectronic vapor product declined from 2014 to 2016 (Table 3.32). In 2016, 17 percent of County high school students reported drinking alcohol, which was lower than the state rate of 25.5 percent in 2017. Similarly, fewer high school students in the Co


 (Table 3.34).
Table 3.34.
Voter Turnout, 2010–2018
General Election
2010
2012*
2014
2016*
2018
SOURCE: Maryland State Board of Elections, 2019. NOTES: *Indicates presidential election.
Stakeholder Insights
Prince George’s
County Maryland
Percent Per


ounty, Maryland
limited school gym spaces, and few places to exercise in the community contribute to the problems of childhood obesity. In addition, one participant noted that there are few options for younger children to engage in outdoor recreation


d requesting funding. I didn’t know about a lot of these programs. Why don’t they coordi- nate what these programs are doing?
One participant noted several examples of social media partnerships that have improved communication about county services.


ends who are still alive. I have fewer men to call because they’re not staying around.
In the area of health issues, stakeholders were particularly concerned about mental and behavioral health, including among people experiencing homelessness. In dat


ow to incorporate volunteers in an efficient way.
Among seniors, there was interest in having County services that foster engagement to reduce isolation and improve health. Stakeholders explained that isolation can lead to depres- sion which in turn


bacco use, lack of exercise, unhealthy diet) are more common among adults with less education.
• Large inequities for infant outcomes were observed, with Black infants having the highest rates of low birthweight and infant mortality.
• Concerns about